Health literacy test for limited literacy populations (HELT-LL): validation in South Africa

The majority of health literacy measures emanate from high-income countries and are inappropriate for use in limited literacy individuals who are usually excluded from participation in health literacy studies. There is currently no appropriate health literacy measure for the educationally diverse South African population. This study, which reports the validation of the Health Literacy Test for Limited Literacy individuals (HELT-LL), was conducted in primary health-care clinics with 210 isiXhosa-speaking patients with a maximum of 12 years of schooling. The HELT-LL has varied cognitive demands, assesses functional literacy skills as well as local burden of disease knowledge, and also includes self-reported questions