Objectives: Health literacy is associated with health knowledge, behavior, and outcomes. Availability of valid measures of health literacy that require minimal time and resources to administer may provide a valuable resource for researchers and healthcare providers. We investigated the psychometric properties of brief, written tests of two components of health literacy--print literacy and numeracy--among American Indians and Alaska Natives.
Design: Secondary analysis of baseline data from the Special Diabetes Program for Indians Healthy Heart Project.
Setting: Thirty health care programs participate in the project. They span 13 states and include Indian Health Service hospitals/clinics/service units as well as tribal and urban Indian health care programs.
Participants: 3,033 American Indian and Alaska Native adults with diabetes.
Main outcome measures: Internal consistency was investigated for the print literacy items. Construct validity analyses examined the expected association of print literacy and numeracy with demographic characteristics and four measures of disease knowledge.
Results: The print literacy items demonstrated acceptable internal consistency. Print literacy and numeracy were more limited among older people and those with lower income and education. Both measures were strong predictors of disease knowledge.
Conclusions: Results support the value of the brief tests of print literacy and numeracy, and represent the first examination of the performance of health literacy measures in the American Indian and Alaska Native population.