Abstract
Background: The ability to understand orally communicated health-related messages is a critical component of health literacy. Recent attention has focused primarily on the prevalence and impact of inadequate health literacy with regard to written communication, largely ignoring that the majority of health information is communicated orally. Most Americans rely on physicians or television for health information, but there is an alarming lack of information on how well people comprehend orally presented health information. We will report on our efforts to develop and validate a computer-based assessment of health literacy–oral around cancer prevention and screening.
Methods: Our methods include a multi-step test development process, beginning with iterative team reviews of the dimensions to be considered in test development, a literature review and member interviews to identify potentially confusing terms and concepts, and collection of sample messages from the media and simulated physician–patient encounters to provide a basis for the actual test items.
Results: Our process identified 13 dimensions to be considered in selecting and scripting the cancer prevention and screening messages that will be included in the assessment. Four of these dimensions are (1) the purpose of the message (instructional, informational/ didactic, or query), (2) message style (narrative, statistical, or factual), (3) setting/context (messages available to the public, including those delivered via radio, television, or internet; messages delivered to the individual including messages delivered in physician-patient encounters, or in person or telephone encounters with other healthcare providers), and (4) content (e.g., cancer causes, screening, risk, epidemiology). The presentation will include full descriptions of all 13 dimensions with illustrative examples, the results of the iterative test specification process and sample items.
Conclusions: We have successfully completed the first steps in developing a test to assess comprehension of health literacy oral in the context of cancer prevention and screening. The next steps include soliciting feedback on our methods and results to date, and suggestions for pilot testing and refining our materials.
- Received September 11, 2008.
