Health Literacy -> Development & Administration

Of Special Note
The health-related assessment questions are embedded in the main NAAL assessment booklet; they are not given separately like FAN or ALSA. That way, they can be scored along each PDQ (prose, document, and quantitative) scale as well as the separate health literacy scale.
The 2003 NAAL Background Questionnaire includes 10 health-related questions that cover self-reported health status, sources of health information (e.g. the Internet), health insurance status, and preventive health practices (e.g., getting a mammogram). NAAL analysis correlates performance on the NAAL health literacy component with data from the health-related background questions.

NAAL defines health literacy as the ability to use printed and written information associated with a broad range of health-related tasks to accomplish oneís goals at home, in the workplace, and in the community (including health care settings).

Another aspect of health literacy is oral communication, such as the ability to orally comprehend what a doctor, nurse, or pharmacist says about the main problem, what to do about the problem, and why it is important to take immediate action. However, NAAL is not designed to assess the skills associated with listening and speaking because of the costs and difficulty of measuring them. It also does not measure knowledge of health issues, such as how to prevent hypertension, nor does it assess understanding of medical jargon or scientific terms. The NAAL health literacy component only measures adultsí ability to perform literacy tasks using written and printed health-related information.

figure of health literacy

SOURCE: U.S. Department of Education, Institute for Education Sciences, National Center for Education Statistics, National Assessment of Adult Literacy (NAAL)

Health Literacy Component Tasks and Stimulus Materials

NAAL includes 28 health-related assessment questions, 2 from the 1992 NALS and 26 new tasks that are specifically designed to measure health literacy. In collaboration with HHS and health literacy experts, NAAL developers identified three types of health literacy tasks—clinical, preventive, and navigation—with which they could calculate a separate health literacy score.

Most of the health literacy component tasks are preventive (14) and navigation (10) because they apply to a wide range of people in the population. On the other hand, most clinical tasks and materials deal with a specific disease or condition. Because clinical tasks generally relate to the specifics of a patientís treatment, they often do not apply to as large a proportion of the population. View a sample health-related question.

Stimulus Materials. NAAL uses 12 health-related stimulus materials that are authentic and reflect the type of materials adults encounter in real life. They include medical instructions, medication information, health insurance and other forms, and prevention and wellness information.