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The Diabetes Educator
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Development and Validation of a Literacy Assessment Tool for Persons With Diabetes

Charlotte Reese Nath, BSN, MSN, EdD

WVU Health Sciences Center, Department of Family Medicine, PO Box 9152, Morgantown, WV 26506-9152 nathc{at}rcbhsc.wvu.edu

Shirley Theriot Sylvester, PhD

Department of Reading, California University of Pennsylvania, California, Pennsylvania

Van Yasek, PhD

Department of Family Medicine, West Virginia University, Morgantown

Erdogan Gunel, PhD

Department of Statistics, West Virginia University, Morgantown

PURPOSE

this research was conducted to develop a valid, reliable, quick, and nonstigmatizing tool for assessing literacy in the healthcare setting.

METHODS

The Literacy Assessment for Diabetes (LAD) instrument was developed as a word recognition test composed of 3 graded word lists in ascending difficulty. This literacy test, which was specific to diabetes, measured a patient's ability to pronounce terms that they would encounter during clinic visits and in reading menu and self-care instructions. The majority of the terms were on a 4th-grade reading level, with the remaining words ranging from the 6th- through 16th-grade levels. To assess reliability and validity, the LAD was compared with the Wide Range Achievement Test (WRAT3) and the Rapid Estimate of Adult Literacy in Medicine (REALM) by administering all 3 tests to 203 participants in a test-retest study design.

RESULTS

All 3 tests (LAD, REALM, and WRAT3) reliably detected true intrasubject variation in word recognition from test to retest. In addition, LAD measured word recognition ability similar to the REALM and WRAT3.

CONCLUSIONS

The LAD is a reliable and valid instrument for measuring literacy in adults with diabetes. It can be administered in 3 minutes or less, and the raw score is scaled to a reading grade level.

The Diabetes Educator, Vol. 27, No. 6, 857-864 (2001)
DOI: 10.1177/014572170102700611
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