Evidence map›Paper›PMID 40558381›Full record

ArticleHealth promotion international2025

Validation of the Assessments of Adult Health Literacy: a Rasch measurement model approach.

Sasha A Fleary, Monique Millington

Abstract readValidation Study
In one paragraph

Article in Health promotion international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. The Reduced Multi-Dimensional Health Literacy Scale: A First Bilingual Validation Using RASCH Analysis.International journal of environmental research and public health · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

Sasha A FlearyPast address: Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, MA, United States.ORCID 0000-0001-9237-2407
Monique MillingtonCUNY Institute of Implementation Science in Population Health, 55 W 125th Street, 6th Floor New York, NY 10027, United States.

Funding

Tufts BIRCWH ProgramK12HD092535 · NICHD · TUFTS UNIVERSITY BOSTON · PI FREUND, KAREN, JAFFE, IRIS Z · 2017 to 2023
$4.3M
National Institute of Health 1K12HD092535National Institute of Health L30DK126209NICHD NIH HHS K12 HD092535NIDDK NIH HHS L30 DK126209
6 · The paper itself

Abstract

Health literacy (HL) is implicated in medical adherence, preventive health, mental health help-seeking, and health decision-making. HL includes three core areas/qualities: functional, interactive/communicative, and critical. Though HL is important in health and health decision-making, research on HL is relatively limited, with most research focused on functional HL. A contributing factor to this research gap is the lack of interactive and critical HL assessments. To address this gap, this study modified and assessed the validity of the Assessments of Adolescent Health Literacy, test-based assessments of functional, interactive, and critical HL, in an adult sample. Adults (n = 2346) completed a measurement battery that included the modified Assessments of Adult Health Literacy (AAHL-Adult) item bank (12 functional, 15 interactive, and 9 critical HL questions), Newest Vital Sign, Single-Item Literacy Scale, demographics, and questions about HL-related behaviours. The assessments were evaluated and validated using Rasch measurement models. Convergent and criterion validity were assessed. The final 6-item functional, 7-item interactive, and 7-item critical HL assessments and their composite (20 items) fit their respective Rasch models. Item-level invariance was established for gender, race, ethnicity, education, and age across all assessments. Good convergent validity with the Newest Vital Sign and Single-Item Literacy Scale and good criterion validity with the HL-related behaviours were observed for all assessments. The AAHL-Adult is the first test-based instrument validated in USA that includes assessments of all three core qualities of HL. These assessments have utility across multiple settings, including public health program planning and evaluation, intervention development and evaluation, and clinical settings.

Indexed as

Health LiteracyAdolescentAdultAgedFemaleHumansMaleMiddle AgedPsychometricsReproducibility of ResultsSurveys and QuestionnairesYoung Adultcommunicative health literacycritical health literacyfunctional health literacyhealth communicationhealth literacyinteractive health literacymeasurement

Identifiers

PMID40558381
PMCPMC12188525

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.