Patient Safety: Assessing Adolescent Health Literacy

11th Dec 2017

Imagine being released from the hospital with a confusing diagnosis, stacks of papers to read and more questions than answers about what to do next.


The “REALM-TeenS” tool can quickly assess how well teens understand health information.

That is the reality for a large percentage of Americans; including teenagers. Many have a limited ability to obtain, process and understand health information and services presented to them – also known as low health literacy. Yet, adolescent health literacy research remains limited compared with adult populations.

A new study, published in Pediatrics  by an associate professor in Public Health is a collaborative effort to develop a brief assessment tool  to identify adolescent health literacy limitations in less than 30 seconds. It’s called Rapid Estimate of Adolescent Literacy in Medicine, short form “REALM-TeenS.”

The tool requires adolescents to read 10 health-related words from a list of common health care terminology. For example, “diabetes,” “asthma,” “exercise” and “bronchial.” The concept is that if an individual has difficulty pronouncing these words in isolation, he or she is likely to have difficulty with comprehension.

Studies indicate low health literacy is linked to negative health outcomes in adults., however, limited research has been performed with adolescents.  REALM-TeenS offers researchers and clinicians a brief screening tool that can be used to quickly assess adolescent health literacy in a variety of settings.

“REALM-TeenS” is a shorter version of a longer assessment tool “REALM-Teen,” which was developed in 2006 by Terry Davis of the Louisiana State University Health Sciences Center, one of the new study collaborators. The original tool required adolescents to read 66 health-related words in three minutes.

The health literacy scores from the 10-word assessment correlated highly (92 percent) with the 66-word assessment and decision consistency was 80 percent across both forms. The researchers compared data from two sources, including a total of 665 youth aged 12 to 19 years old.

Health professionals and researchers have limited time with patients, but hopefully this new tool will provide the incentive to measuring health literacy when working with adolescent populations.  This is especially important for helping care teams effectively communicate important health information, medication instructions, and follow-up supports.


This blog originally appeared in Christina’s Considerations. The information contained in this publication is the property of Texas Insight and is considered confidential and may contain proprietary information. It is meant solely for the intended recipient. Access to this published information by anyone else is unauthorized unless Texas Insight grants permission.  If you are not the intended recipient, any disclosure, copying, distribution or any action taken or omitted in reliance on this is prohibited.  The views expressed in this publication are, unless otherwise stated, those of the author and not those of Texas Insight or its management.