Optimal health literacy measurement for the clinical setting: A systematic review

Abstract

Objective: To identify the optimal measurement instrument for assessing health literacy in a clinical setting.

Methods: Seven databases were searched for studies evaluating health literacy instruments used with patients. Standardised systematic review methods were used by two reviewers independently assessing eligibility, extracting data and evaluating study quality. A narrative summary was produced.

Results: The searches identified 626 articles of which 64 were eligible. Forty-three different health literacy instruments were identified. The quality of these instruments, based on their psychometric properties, varied considerably. The majority of health literacy instruments were found to only assess communicative health literacy of which the numeracy element was often not represented. The NVS instrument was found to be the most practical health literacy instrument to use.

Conclusion: There is an urgent need to develop and psychometrically test a more encompassing health literacy instrument applicable in clinical settings as well as health promotion in general.

Practice implications: In the absence of a more comprehensive health literacy instrument, the NVS is a practical instrument to quickly assess for health literacy in a clinical setting.

Keywords: Health literacy.