Is the Cloze Procedure Appropriate to Evaluate Health Literacy in Older Individuals? Age Effects in the Test of Functional Health Literacy in Adults

Health literacy has received increasing attention because of its importance for older individuals’ health, as studies have shown a close relation between older individuals’ health literacy and their health. Research also suggests that older individuals have low levels of health literacy, but this fi...

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Main Authors: Raymond L. Ownby, Amarilis Acevedo, Drenna Waldrop-Valverde, Robin J. Jacobs
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Journal of Aging Research
Online Access:http://dx.doi.org/10.1155/2014/194635
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author Raymond L. Ownby
Amarilis Acevedo
Drenna Waldrop-Valverde
Robin J. Jacobs
author_facet Raymond L. Ownby
Amarilis Acevedo
Drenna Waldrop-Valverde
Robin J. Jacobs
author_sort Raymond L. Ownby
collection DOAJ
description Health literacy has received increasing attention because of its importance for older individuals’ health, as studies have shown a close relation between older individuals’ health literacy and their health. Research also suggests that older individuals have low levels of health literacy, but this finding is variable and may depend on which health literacy test is used. Older individuals assessed with the Test of Functional Health Literacy (TOFHLA) score lower than younger individuals, but a previous study suggested that this may result from age-related differential item functioning (DIF) on the TOFHLA. The study reported here assessed age-related DIF in a sample of community-dwelling volunteers. Twenty-two percent of items were differentially more difficult for older individuals independent of their overall ability, and when these items were eliminated from the total score, age differences were no longer found. Performance on a working memory task predicted older but not younger individuals’ performance on the age-related items. At least part of older individuals’ apparent deficits in health literacy when assessed by the TOFHLA may be related to DIF on its items. The TOFHLA, and any measure that employs the cloze procedure to evaluate reading comprehension, should be used cautiously in older individuals.
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spelling doaj-art-337ca3f112c94a68be50f9caf310f8c72025-02-03T01:25:05ZengWileyJournal of Aging Research2090-22042090-22122014-01-01201410.1155/2014/194635194635Is the Cloze Procedure Appropriate to Evaluate Health Literacy in Older Individuals? Age Effects in the Test of Functional Health Literacy in AdultsRaymond L. Ownby0Amarilis Acevedo1Drenna Waldrop-Valverde2Robin J. Jacobs3Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USACenter for Psychological Studies, Nova Southeastern University, Fort Lauderdale, FL 33314, USANell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USADepartment of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USAHealth literacy has received increasing attention because of its importance for older individuals’ health, as studies have shown a close relation between older individuals’ health literacy and their health. Research also suggests that older individuals have low levels of health literacy, but this finding is variable and may depend on which health literacy test is used. Older individuals assessed with the Test of Functional Health Literacy (TOFHLA) score lower than younger individuals, but a previous study suggested that this may result from age-related differential item functioning (DIF) on the TOFHLA. The study reported here assessed age-related DIF in a sample of community-dwelling volunteers. Twenty-two percent of items were differentially more difficult for older individuals independent of their overall ability, and when these items were eliminated from the total score, age differences were no longer found. Performance on a working memory task predicted older but not younger individuals’ performance on the age-related items. At least part of older individuals’ apparent deficits in health literacy when assessed by the TOFHLA may be related to DIF on its items. The TOFHLA, and any measure that employs the cloze procedure to evaluate reading comprehension, should be used cautiously in older individuals.http://dx.doi.org/10.1155/2014/194635
spellingShingle Raymond L. Ownby
Amarilis Acevedo
Drenna Waldrop-Valverde
Robin J. Jacobs
Is the Cloze Procedure Appropriate to Evaluate Health Literacy in Older Individuals? Age Effects in the Test of Functional Health Literacy in Adults
Journal of Aging Research
title Is the Cloze Procedure Appropriate to Evaluate Health Literacy in Older Individuals? Age Effects in the Test of Functional Health Literacy in Adults
title_full Is the Cloze Procedure Appropriate to Evaluate Health Literacy in Older Individuals? Age Effects in the Test of Functional Health Literacy in Adults
title_fullStr Is the Cloze Procedure Appropriate to Evaluate Health Literacy in Older Individuals? Age Effects in the Test of Functional Health Literacy in Adults
title_full_unstemmed Is the Cloze Procedure Appropriate to Evaluate Health Literacy in Older Individuals? Age Effects in the Test of Functional Health Literacy in Adults
title_short Is the Cloze Procedure Appropriate to Evaluate Health Literacy in Older Individuals? Age Effects in the Test of Functional Health Literacy in Adults
title_sort is the cloze procedure appropriate to evaluate health literacy in older individuals age effects in the test of functional health literacy in adults
url http://dx.doi.org/10.1155/2014/194635
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