The Cancer Message Literacy Tests: psychometric analyses and validity studies

Abstract

OBJECTIVE: To examine the psychometric properties of two new health literacy tests, and to evaluate score validity. METHODS: Adults aged 40-71 completed the Cancer Message Literacy Test-Listening (CMLT-Listening), the Cancer Message Literacy Test-Reading (CMLT-Reading), the REALM, the Lipkus numeracy test, a brief knowledge test (developed for this study) and five brief cognitive tests. Participants also self-reported educational achievement, current health, reading ability, ability to understand spoken information, and language spoken at home. RESULTS: Score reliabilities were good (CMLT-Listening: alpha=.84) to adequate (CMLT-Reading: alpha=.75). Scores on both CMLT tests were positively and significantly correlated with scores on the REALM, numeracy, cancer knowledge and the cognitive tests. Mean CMLT scores varied as predicted according to educational level, language spoken at home, self-rated health, self-reported reading, and self-rated ability to comprehend spoken information. CONCLUSION: The psychometric findings for both tests are promising. Scores appear to be valid indicators of comprehension of spoken and written health messages about cancer prevention and screening. PRACTICE IMPLICATIONS: The CMLT-Listening will facilitate research into comprehension of spoken health messages, and together with the CMLT-Reading will allow researchers to examine the unique contributions of listening and reading comprehension to health-related decisions and behaviors.