WLS Codebooks

Note: Codebooks contain frequency data from the private data release. For some variables, these differ from the frequencies in the public release. Variables that differ between the public and private versions include "(not available on public release)" as part of the variable description, or a note indicating the difference between the public and private versions.

In Person: Short Test of Functional Health Literacy in Adults (STOFHLA)

KSTOF  Short Test of Functional Health Literacy in Adults (STOFHLA) Module

OVERVIEW

The Short Test of Functional Health Literacy in Adults (STOFHLA) Module is new
to the 2011 collection wave. At its core is a reading comprehension assessment
known as the "Short Test of Functional Health Literacy in Adults (STOFHLA)."
Although an abridged version of the "Test of Functional Health Literacy in
Adults (TOFHLA)," STOFHLA is likewise premised on the notion that successfully
navigating the health care system requires a level of literacy greater than
what is typically acquired in the conventional classroom. When being assessed,
patients are asked to read and complete passages that might be found in health
care settings by inserting missing words at selected intervals. More
specifically, they are prompted to choose the correct word from a list of four
possibilities at each place where a word has been removed from the text. Two
generic passages are used: the first, which has sixteen missing words, is a set
of instructions disseminated to patients prior to an upper GI series (X-ray
examination) while the second, which has twenty missing words, comes from the
patient rights and responsibilities section of a Medicaid application form.
Possessing discrepant levels of intelligiblity, the first passage is at a 4th
grade reading level (4.3 on the Gunning Fog index) while the second is at a
10th grade level (10.4 on the Gunning Fog index). Note that although the
STOFHLA is a timed assessment to which seven minutes are allotted for
completion, the patient is never told as much and simply asked to stop if they
haven't finished after seven minutes. Functional health literacy scores are
computed as the sum of patients' correct answers to the thirty-six total items
comprising the STOFHLA. It is recommended that scores be interpreted as
follows:

     STOFHLA Score  	Functional Health Literacy Level

     0-16		Inadequate: unable to read and interpret health texts.

     17-22		Marginal: has difficulty reading and interpreting 
     			health texts.

     23-36		Adequate: can read and interpret most health texts.

If the patient scores at the marginal or inadequate levels of functional health
literacy, it is unlikely that they will be able to read and understand health
care instructions. Such patients are at increased risk for improperly taking
medications and failing to satisfy the tenets of prescribed diets or treatment
regimens; health care providers must make modifications to normal operating
procedures if they wish to accommodate the needs of patients such as these.  

Within the context of the CAPI interview, the STOFHLA was administered to
participants just as it would have been if they were visiting a doctor's
office: participants were given a booklet containing the two health care
passages and instructed to fill it out by hand, indicating which possibility
they believed made the most sense at each missing word by marking an "X" in the
selection box alongside one of the four answer choices. If the participant had
not completed the task after seven minutes, they were instructed to stop. A
functional health literacy score was computed for all participants who agreed
to be assessed. For a sample version of the STOFHLA replicating the passages,
missing words, and answer possibilities used during the CAPI interview, please
visit http://www.nmmra.org/resources/Physician/152_1485.pdf.


BRIEF VARIABLE DESCRIPTIONS

    Variable ranges reference dataset/codebook order and are not necessarily 
    alphabetical.
    _____________________________________________________________________

    KSTOSTAT-KSTOREL:	    Module-Level Status Variables

    KI800RE:		    Random 8% Sub-Sampling Flag Dictating 
    			    Whether STOFHLA Administered to Participant
    			    
    KI800REA:		    Flag for Outcome of STOFHLA Assessment
    
    KI800RED:		    Number of STOFHLA Items Attempted If 
    			    Participant Completed the Assessment
    
    KI874RE:		    Functional Health Literacy Level: Assessment
    			    Completed and all STOFHLA Items Attempted
    
    KI875RE:		    Functional Health Literacy Level: Assessment
    			    Completed 
    			    
    KI801RE-KI816RE:	    Indicators for How Participant Answered 
    			    Each STOFHLA Item in Passage #1
    
    KI817RE-KI836RE:	    Indicators for How Participant Answered
    			    Each STOFHLA Item in Passage #2
    
    KI837RE-KI852RE:	    Summary of How Participant's Answer to Each
    			    STOFHLA Item in Passage #1 Was Scored
    			    
    KI853RE-KI872RE:	    Summary of How Participant's Answer to Each
    			    STOFHLA Item in Passage #2 Was Scored

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