Comprende la información sobre su salud?: A review of health literacy research for the Hispanic population

BACKGROUND: National literacy survey data indicate that Hispanics comprise the lowest-scoring ethnic group in the U.S. Low functional literacy, limited-English-proficiency, and limited linguistic and cultural competence among health care providers affect Hispanics' health literacy skills, increasing health disparities for this population. This is the first systematic review of health literacy research focused on this population.

OBJECTIVES: 1) To examine the focus, design, and characteristics of Hispanic health literacy studies, and 2) To identify instruments used to assess health literacy among Hispanics.

METHODS: A comprehensive search of five electronic databases resulted in a sample of 29 studies published between 1992 and 2008 which were examined for study design, focus, health literacy definitions, and measurement tools.

RESULTS: Of the 29 studies, only 8 defined literacy and 13 defined health literacy. Researchers measured health literacy through surveys, TOFHLA, Shortened TOFHLA, SAHLSA, REALM, and Newest Vital Sign. Few studies used Spanish language instruments (e.g., TOFHLA-S). Specific health topics included HIV, cancer, diabetes, asthma, nutrition, treatment adherence, and child health.

CONCLUSIONS: Inconsistency in the definition and measurement of health literacy was an identified limitation across the recent research among Hispanics. Further research based on consistent definitions of health literacy and using culturally sensitive health literacy assessment tools is needed. Implications for practice include the need for health educators and providers to better assess Hispanics' understanding of health information. Cultural and linguistic contexts add to the challenges of adequately assessing and improving health literacy among Spanish-speaking Hispanics.