A comparison of health literacy measurement tools in a sample of college students

Health literacy is an important predictor of health behavior and health outcomes, yet its measurement remains challenging. This study assessed health literacy measurement tools among college students to provide recommendations for future research. A sample of 122 college students completed a survey including the Single Item Health Literacy Screener (SILS) as well as three additional health literacy assessments. These included the Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen), Newest Vital Sign (NVS), and Short Test of Functional Health Literacy in Adults (S-TOFHLA). All scored high on the S-TOFHLA, but participants with lower health literacy emerged with the SILS (21%), REALM-Teen (17%), and NVS (13%). Logistic regression analysis identified race, home language, and father’s education as predictors of low health literacy, but this varied by tool. The sensitivity of the four measurement tools also varied. Continued assessment of existing tools and exploration of new measures can advance the study of health literacy and health behavior.