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The Newest Vital Sign: A New Health Literacy

Assessment Tool for Health Care Providers

The Newest Vital Sign is a bilingual (English and Spanish) screening tool that identifies patients at risk for low health literacy. The tool can be administered in a clinical setting in just three minutes. The test result provides information about the patient that will allow providers to appropriately adapt their communication practices in an effort to achieve better health outcomes.

The Newest Vital Sign (NVS) is Pfizer Inc's latest contribution to the health literacy movement, and has been researched by health literacy experts at the University of Arizona College of Medicine in collaboration with colleagues at the University of North Carolina.

After testing with more than 1,000 patients, the NVS has been shown to address some of the limitations of previously available instruments. As with previous instruments, the Newest Vital Sign assesses general literacy and numeracy skills as applied to health information, yielding an overall estimate of health literacy. In contrast to the previous instruments, however, it can be administered in about three minutes and is available in both English and Spanish.

How Does the Newest Vital Sign Work?

The Newest Vital Sign is based on a nutrition label from an ice cream container. Patients are given the label and then asked 6 questions about how they would interpret and act on the information contained on the label.

Specifically, the patient is handed a copy of the nutrition label and then asked a series of 6 questions about it. Patients can and should retain the label so they can refer to it while answering questions. It is not necessary to give the patient time to review the label before asking the questions. Rather, they will review the label as they are asked and answer the questions.

The questions are asked orally and the responses recorded by a health care provider on a special score sheet, which contains the correct answers. Based on the number of correct responses, the health care provider can assess the patient's health literacy level.

What Can Providers Do to Improve Patient Understanding?

If the Newest Vital Sign results indicate a patient has limited health literacy skills, providers can use simple and fast clear health communication techniques to help patients better understand their medical issues and follow instructions, which may positively impact their health outcomes.

What Research Supports the Newest Vital Sign?

The Newest Vital Sign has been tested with more than 1,000 English and Spanish-speaking adults. The first peer-reviewed clinical study of the NVS, Quick Assessment of Literacy in Primary Care: The Newest Vital Sign, was published in the Annals of Family Medicine (December 2005). In this study, the NVS was validated against the TOHFLA and was shown to take approximately three minutes to administer.

Further research is in development to test the NVS in combination with various clear health communication interventions.







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