Health Literacy and Numeracy Screening Tools12, 13

The following tools are available to assist in assessing patients’ health literacy.

Rapid Estimate of Adult Literacy in Medicine (REALM)14

Keep the profession strong and moving forward through active engagement. Learn, participate and contribute in discussions on matters affecting the profession through Speaker reports and webinar opportunities.

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Rapid Estimate of Adult Literacy in Medicine (Short) (REALM-R)15

8-item list of common medical terms for patient to read aloud; used to assess literacy and estimate reading level

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Newest Vital Sign (NVS)16

6-item general questions based on a nutrition label; used to assess comprehension and numeracy

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Single Item Screener (SILS)17

1-item self-assessment question on ability to understand information from health care providers; used to identify inadequate health literacy

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Subjective Numeracy Scale (SNS)18

8-item self-assessment scale; used to assess general numeracy skills (fractions, percentages, etc.)

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Shortened Subjective Numeracy Scale (SNS-3)19

3-item self-assessment regarding mathematical ability and preferences; used to assess general numeracy

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  1. Health literacy tool shed. Boston Univeristy, CommunicateHealth, NIH NLM. Updated 28 November 2020. Accessed 28 November 2020.
  2. Caruso R, Magon A, Baroni I, et al. Health literacy in type 2 diabetes patients: a systematic review of systematic reviews. Acta Diabetol. 2018;55(1):1-12. doi:10.1007/s00592-017-1071-1
  3. Davis TC, Crouch MA, Long SW, et al. Rapid assessment of literacy levels of adult primary care patients. Fam Med. 1991;23(6):433-435.
  4. Bass PF 3rd, Wilson JF, Griffith CH. A shortened instrument for literacy screening. J Gen Intern Med. 2003;18(12):1036-1038. doi:10.1111/j.1525-1497.2003.10651.x
  5. Weiss BD, Mays MZ, Martz W, et al. Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med. 2005;3(6):514-522. doi:10.1370/afm.405
  6. Morris NS, MacLean CD, Chew LD, Littenberg B. The single item literacy screener: evaluation of a brief instrument to identify limited reading ability. BMC Fam Pract. 2006;7:21. doi:10.1186/1471-2296-7-21
  7. Fagerlin A, Zikmund-Fisher BJ, Ubel PA, Jankovic A, Derry HA, Smith DM. Measuring numeracy without a math test: development of the Subjective Numeracy Scale. Med Decis Making. 2007;27(5):672-680. doi:10.1177/0272989X07304449
  8. McNaughton CD, Cavanaugh KL, Kripalani S, Rothman RL, Wallston KA. Validation of a short, 3-item version of the Subjective Numeracy Scale. Med Decis Making. 2015;35(8):932-936. doi:10.1177/0272989X15581800

Chronic Diseases