Abilities, skills and knowledge in measures of health literacy.

OBJECTIVE: Health literacy has been recognized as an important factor in patients\u27 health status and outcomes, but the relative contribution of demographic variables, cognitive abilities, academic skills, and health knowledge to performance on tests of health literacy has not been as extensively explored. The purpose of this paper is to propose a model of health literacy as a composite of cognitive abilities, academic skills, and health knowledge (ASK model) and test its relation to measures of health literacy in a model that first takes demographic variables into account. METHODS: A battery of cognitive, academic achievement, health knowledge and health literacy measures was administered to 359 Spanish- and English-speaking community-dwelling volunteers. The relations of health literacy tests to the model were evaluated using regression models. RESULTS: Each health literacy test was related to elements of the model but variability existed across measures. CONCLUSION: Analyses partially support the ASK model defining health literacy as a composite of abilities, skills, and knowledge, although the relations of commonly used health literacy measures to each element of the model varied widely. PRACTICE IMPLICATIONS: Results suggest that clinicians and researchers should be aware of the abilities and skills assessed by health literacy measures when choosing a measure