Development and Validation of the Spanish Numeracy Understanding in Medicine Instrument. J Gen Intern Med 2016 Nov;31(11):1345-1352
Date
10/21/2016Pubmed ID
27312095Pubmed Central ID
PMC5071279DOI
10.1007/s11606-016-3759-2Scopus ID
2-s2.0-84975166262 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
BACKGROUND: The Spanish-speaking population in the U.S. is large and growing and is known to have lower health literacy than the English-speaking population. Less is known about the health numeracy of this population due to a lack of health numeracy measures in Spanish.
OBJECTIVE: we aimed to develop and validate a short and easy to use measure of health numeracy for Spanish-speaking adults: the Spanish Numeracy Understanding in Medicine Instrument (Spanish-NUMi).
DESIGN: Items were generated based on qualitative studies in English- and Spanish-speaking adults and translated into Spanish using a group translation and consensus process. Candidate items for the Spanish NUMi were selected from an eight-item validated English Short NUMi. Differential Item Functioning (DIF) was conducted to evaluate equivalence between English and Spanish items. Cronbach's alpha was computed as a measure of reliability and a Pearson's correlation was used to evaluate the association between test scores and the Spanish Test of Functional Health Literacy (S-TOFHLA) and education level.
PARTICIPANTS: Two-hundred and thirty-two Spanish-speaking Chicago residents were included in the study.
KEY RESULTS: The study population was diverse in age, gender, and level of education and 70 % reported Mexico as their country of origin. Two items of the English eight-item Short NUMi demonstrated DIF and were dropped. The resulting six-item test had a Cronbach's alpha of 0.72, a range of difficulty using classical test statistics (percent correct: 0.48 to 0.86), and adequate discrimination (item-total score correlation: 0.34-0.49). Scores were positively correlated with print literacy as measured by the S- TOFHLA (r = 0.67; p < 0.001) and varied as predicted across grade level; mean scores for up to eighth grade, ninth through twelfth grade, and some college experience or more, respectively, were 2.48 (SD ± 1.64), 4.15 (SD ± 1.45), and 4.82 (SD ± 0.37).
CONCLUSIONS: The Spanish NUMi is a reliable and valid measure of important numerical concepts used in communicating health information.
Author List
Jacobs EA, Walker CM, Miller T, Fletcher KE, Ganschow PS, Imbert D, O'Connell M, Neuner JM, Schapira MMAuthors
Kathlyn E. Fletcher MD Professor in the Medicine department at Medical College of WisconsinJoan Neuner MD, MPH Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Comprehension
Female
Health Knowledge, Attitudes, Practice
Health Literacy
Humans
Male
Middle Aged
Reproducibility of Results
Surveys and Questionnaires
Translating
