Brief Health Literacy Screening Items Predict Newest Vital Sign Scores

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Figure 1.
Distribution of Newest Vital Sign (NVS) scores.
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Figure 2.
Receiving operating characteristic (ROC) curves for health literacy (A) and numeracy screening (B) items in detecting limited Newest Vital Sign scores.
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Figure 3.
Receiving operating characteristic (ROC) curves for health literacy (A) and numeracy screening (B) items in detecting limited/marginal Newest Vital Sign scores.

Table 1. Sociodemographic Characteristics of the Study Sample (n = 241)

Sociodemographic Characteristics	Mean ± Standard Deviation or Frequency	Percentage
Age (years)	46.1 ± 16.3	—
Sex
Male	70	29.0
Female	171	71.0
Race
Asian	2	0.8
Black	127	53.4
White	109	45.8
Educational attainment
<High school	18	7.5
High school graduate	55	23.0
Some college	87	36.4
College graduate	79	33.1
Health insurance status
Medicaid	68	28.2
Medicare	39	16.2
Private/commercial	125	15.9
Self-pay	8	3.3
Other	1	0.4
Self-rated health status
Poor/fair	61	25.3
Good	81	33.6
Very good/excellent	99	41.1

Table 2. Performance of Health Literacy and Numeracy Screening Items in Detecting Limited Newest Vital Sign Scores

Screening Item	Scale^*	Sensitivity (%)	Specificity (%)
How often do you have problems learning about your medical condition because of difficulty understanding written information?	Always	100	0
	Often	58.1	61.1
	Sometimes	30.2	85.9
	Occasionally	9.3	97.5
	Never	2.3	99.5
How often do you have someone help you read hospital materials?	Always	100	0
	Often	58.1	76.8
	Sometimes	39.5	89.9
	Occasionally	18.6	95.9
	Never	4.7	98.5
How confident are you filling out medical forms by yourself?	Extremely	100	0
	Quite a bit	62.8	62.1
	Somewhat	39.5	89.9
	A little bit	16.3	97.9
	Not at all	4.7	98.9
In general, how easy or hard do you find it to understand medical statistics?	Very easy	100	0
	Easy	88.4	21.8
	Hard	34.9	81.7
	Very hard	11.6	98.9
How much do you agree or disagree with the following statement? In general, I depend on numbers and statistics to help me make decisions about my health.	Strongly agree	100	0
	Somewhat agree	79.1	16.2
	Somewhat disagree	37.2	65.7
	Strongly disagree	13.9	87.9

↵* Relative comparisons of the underlying degree or frequency; categories do not necessarily correspond to the actual numeric coding (i.e., the ascending or descending ordering of each Likert scale) of the item responses.

Table 3. Performance of Health Literacy and Numeracy Screening Items in Detecting Limited and Marginal Newest Vital Sign Scores

Screening Item	Scale^*	Sensitivity (%)	Specificity (%)
How often do you have problems learning about your medical condition because of difficulty understanding written information?	Always	100	0
	Often	50.0	62.8
	Sometimes	28.1	90.3
	Occasionally	8.3	99.3
	Never	2.1	100
How often do you have someone help you read hospital materials?	Always	100	0
	Often	46.9	82.1
	Sometimes	31.3	95.2
	Occasionally	15.6	99.3
	Never	4.2	99.3
How confident are you filling out medical forms by yourself?	Extremely	100	0
	Quite a bit	56.3	66.9
	Somewhat	33.3	96.6
	A little bit	11.5	100
	Not at all	4.2	100
In general, how easy or hard do you find it to understand medical statistics?	Very easy	100	0
	Easy	88.4	25.5
	Hard	31.6	85.5
	Very hard	6.3	99.3
How much do you agree or disagree with the following statement? In general, I depend on numbers and statistics to help me make decisions about my health.	Strongly agree	100	0
	Somewhat agree	78.1	13.8
	Somewhat disagree	33.3	64.1
	Strongly disagree	10.4	86.2

↵* Relative comparisons of underlying degree or frequency; categories do not necessarily correspond to the actual numeric coding (i.e., the ascending or descending ordering of each Likert scale) of the item responses.