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Quick screen of patients' numeracy and document literacy skills: the factor structure of the Newest Vital Sign

Authors Huang YM, Shiyanbola OO, Smith PD, Chan HY

Received 20 February 2018

Accepted for publication 4 April 2018

Published 17 May 2018 Volume 2018:12 Pages 853—859

DOI https://doi.org/10.2147/PPA.S165994

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen


Yen-Ming Huang,1 Olayinka O Shiyanbola,1 Paul D Smith,2 Hsun-Yu Chan3

1Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA; 2Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; 3Department of Psychology, Counseling, and Special Education, Texas A&M University-Commerce, Commerce, TX, USA

Introduction: The Newest Vital Sign (NVS) is a survey designed to measure general health literacy whereby an interviewer asks six questions related to information printed on a nutritional label from an ice cream container. It enables researchers to evaluate several health literacy dimensions in a short period of time, including document literacy, comprehension, quantitative literacy (numeracy), application, and evaluation. No study has empirically examined which items belong to which latent dimensions of health literacy in the NVS using factor analysis. Identifying the factor structure of the NVS would enable health care providers to choose appropriate intervention strategies to address patients’ health literacy as well as improve their health outcomes accordingly. This study aimed to explore the factor structure of the NVS that is used to assess multiple dimensions of health literacy.
Methods: A cross-sectional study administering the NVS in a face-to-face manner was conducted at two family medicine clinics in the USA. One hundred and seventy four individuals who participated were at least 20 years old, diagnosed with type 2 diabetes, prescribed at least one oral diabetes medicine, and used English as their primary language. Exploratory factor analysis and confirmatory factor analysis were conducted to investigate the factor structure of the NVS.
Results: Numeracy and document literacy are two dimensions of health literacy that were identified and accounted for 63.05% of the variance in the NVS. Internal consistency (Cronbach’s alpha) of the NVS were 0.78 and 0.91 for numeracy and document literacy, respectively.
Conclusion: Numeracy and document literacy appropriately represent the factor structure of the NVS and may be used for assessing health literacy in greater detail for patients with type 2 diabetes.

Keywords: diabetes, health literacy, numeracy, document literacy, the Newest Vital Sign

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