A Point of Care Evaluation of Health Literacy in a Suburban GI Clinic

Introduction: Health literacy is defined as the ability to obtain, process, and understand basic information needed to make appropriate health decisions. Health literacy has a major impact on the improvement of quality of healthcare. In 2005, a tool was introduced to assess health literacy called new vital sign by Weiss et al. Since then, it has been validated in multiple studies. It is usually administered by an RN or MOA, and takes about 3 minutes to complete. It assesses general literacy and numeracy skills as applied to health information yielding an overall estimate of health literacy. We aimed to assess health literacy in an outpatient community GI clinic. Methods: We enrolled 175 consecutive patients in an ambulatory GI setting. The new vital sign was administered by a medical student after standard vital signs were obtained. Exclusion criteria were <18 years of age, and visual/auditory impairment. When appropriate, the primary caregiver responsible for medical care was administered the test. The patient was given a nutrition label, and then asked predefined questions in order to assess prose literacy, numeracy, and document literacy. The answers were correct or incorrect according to a predefined binary scoring key (1 point for each correct answer [maximum 6 points]). Results: A total of 171 patients completed the test. The average time to complete the test was 3.6 minutes. The number of correct items on the NVS ranged from 0 to 6 (mean=4.41). Of total surveyed, 24 patients scored 0-1, suggesting a high likelihood of limited literacy. 17 patients scored 2-3, indicating the possibility of limited literacy. 130 patients scored 4-6, consistent with adequate literacy. Conclusion: NVS can provide prompt and valuable insight into the patients’ level of health literacy. With this knowledge, physician and ancillary staff can tailor recommendations and instructions appropriately. In this suburban population, more than three-fourths of participants (76%) showed adequate literacy, while nearly one-fourth (24%) showed impaired health literacy. Performance of NVS can lead to improved and focused communication in the physician-patient relationship, leading to improved health care delivery.