A comparative analysis of Spanish health literacy tools: S-TOFHLA & NVS

Two of the most popular health literacy tools are the Test of Functional Health Literacy in Adults (TOFHLA) and the Newest Vital Signs (NVS): both have a Spanish version. The TOFHLA, the “gold standard” for health literacy testing, has shown strong reliability and validity in the English version. A disadvantage is the lack of validity for the Spanish version. The Spanish version of the NVS has also shown inconclusive validity. Therefore, there is a need for additional validity studies on the Spanish versions of the TOFHLA and NVS. Similarly, since both instruments are arbitrarily used for measuring health literacy among Hispanics there is a need for comparative results studies. The purpose of this cross-sectional exploratory study was to assess how the short version of the TOFHLA (S-TOFHLA) and the NVS compare in terms of assessing health literacy levels among Spanish-speaking adults. Participants were recruited from a Migrant High School Equivalency program. Nine-six completed both the S-TOFHLA and the NVS. Survey scores were entered into SPSS for analysis. While S-TOFHLA scores placed more than 90% of participants at the “adequate functional health literacy” level, only 30% reached the “adequate literacy” level according to the NVS. Furthermore, intercorrelations between S-TOFHLA subscales and NVS total scores yielded low to moderate coefficients (S-TOFHLA-A vs. NVS scores = .15; S-TOFHLA-B vs. NVS = .45; Total S-TOFHLA vs. NVS = .41). Results indicate that the Spanish version of the S-TOFHLA and the NVS may not be used arbitrarily for assessing health literacy among Spanish-speaking adults. They measure different dimensions of health literacy, and are not comparable. Further research in this area is recommended.