Short Assessment of Health Literacy for Spanish-Speaking Adults

Domains assessed: Prose: Pronunciation, Prose: Comprehension

Specific context: General

Validation sample population age: Older Adults: 65+ years, Adults: 18 to 64 years

Modes of administration in validation study: Paper and pencil, Face-to-face

Number of items: 50

Sample size in validation study: 403

Administration Time (minutes): 4 minutes

Language of validated version: Spanish

Categorical scoring: No

Scoring categories: Possible range: 0-50, with ≤37 = inadequate HL

Country where validated: United States of America

Content validity: The instrument was developed by an expert panel through a Delphi process. The panel consisted of 5 experts who were fluent in both English and Spanish and had extensive experience working with Spanish speakers in educational, medical, and public health settings. The Delphi process involved 2 steps. The first was translation of the 66 REALM medical terms into Spanish. The translation took into account both the dictionary definition and the commonality of usage in daily conversations. The second step was selection of the key and distractor for each REALM medical term according to 3 criteria: (1) the key and distractor should be no more complicated or difficult than the medical term; (2) the relation of the key to the medical term should be a subset, an example, a larger class, a synonym, or a function; and (3) the distractor should be an incorrect but plausible choice in terms of its association with the medical term and it should be comparable in length and complexity to the key. Discrepancies that arose during the Delphi process were discussed and resolved among panel members during 3 half-day meetings held between December 2002 and March 2003. The Delphi process produced both the English and Spanish drafts of the new instrument.

Reliability notes: IRT: aΔ=2.80 to 0.68, and b□= -2.98 to 0.75