Assessment of Health Literacy andvalidation of single-item literacy screener(SILS) in a sample of Italian people

摘要

Background. Health literacy (HL) is a complex concept with multiple components; itinvolves the ability to effectively use and interpret texts, documents, and numbers. Theaims of our study were: to measure HL levels among a sample of adult Italian patients;to develop and validate the Italian version of the single-item literacy screener (SILS);to assess the diagnostic accuracy of the SILS as an indicator of limited reading abilityregarding health documents, compared to the newest vital sign (NVS).Methods. The subjects were enrolled in emergency departments, primary care settings,and specialist departments. The Italian versions of the NVS and of the SILS were administeredto the patients, as well as a questionnaire aimed in collected socio-demographicinformation.Results. Overall, 174 patients completed the interview (compliance: 87%). Consideringthe NVS, 24.1% of the subjects presented high likelihood of limited HL, 13.2% a possibilityof limited HL, and 62.6% adequate HL. SILS has shown a good concurrent validitycompared to NVS (Spearman’s rho r = -0.679; p < 0.001). The diagnostic accuracy of theSILS was high. The best performance parameters in assessing the diagnostic accuracy ofSILS are found to be for threshold value of 2 in in identifying subjects with high likelihoodof limited HL at the NVS (sensitivity: 83.3%; specificity: 82.6%; accuracy: 82.8%;positive predicted value: 60.3%; negative predicted value: 94%; Cohen’s kappa: 0.6).Conclusion. The Italian version of SILS – as an indicator of limited reading and understandingability regarding health information – is a good tool to measure HL in comparisonto more complex measurement instruments of functional HL, like NVS.