Mary Z. Mays

Quick Assessment of Literacy in Primary Care: The Newest Vital Sign

PURPOSE Current health literacy screening instruments for health care settings are either too long for routine use or available only in English. Our objective was to develop a quick and accurate screening test for limited literacy available in English and Spanish. METHODS We administered candidate items for the new instrument and also the Test of Functional Health Literacy in Adults (TOFHLA) to English-speaking and Spanish-speaking primary care patients. We measured internal consistency with Cronbach’s α and assessed criterion validity by measuring correlations with TOFHLA scores. Using TOFLHA scores <75 to define limited literacy, we plotted receiver-operating characteristics (ROC) curves and calculated likelihood ratios for cutoff scores on the new instrument. RESULTS The final instrument, the Newest Vital Sign (NVS), is a nutrition label that is accompanied by 6 questions and requires 3 minutes for administration. It is reliable (Cronbach α >0.76 in English and 0.69 in Spanish) and correlates with the TOFHLA. Area under the ROC curve is 0.88 for English and 0.72 for Spanish versions. Patients with more than 4 correct responses are unlikely to have low literacy, whereas fewer than 4 correct answers indicate the possibility of limited literacy. CONCLUSION NVS is suitable for use as a quick screening test for limited literacy in primary health care settings.

The Evidence‐Based Practice Beliefs and Implementation Scales: Psychometric Properties of Two New Instruments

BACKGROUND Implementation of evidence-based practice (EBP) by health professionals is a key strategy for improving health care quality and patient outcomes as well as increasing professional role satisfaction. However, it is estimated that only a small percentage of nurses and other health care providers are consistently using this approach to clinical practice. AIM The aim of this study was to report on the development and psychometric properties of two new scales: (1) the 16-item EBP Beliefs Scale that allows measurement of a persons beliefs about the value of EBP and the ability to implement it, and (2) the 18-item EBP Implementation Scale that allows measurement of the extent to which EBP is implemented. METHODS Nurses (N= 394) attending continuing education workshops volunteered to complete the scales. Data were analysed to evaluate reliability and validity of both instruments. RESULTS Cronbachs alpha was > .90 for each scale. Principal components analysis indicated that each scale allowed measurement of a unidimensional construct. Strength of EBP beliefs and the extent of EBP implementation increased as educational level increased (p < .001) and as responsibility in the workplace increased (p < .001). CONCLUSION In this study, initial evidence was provided to support the reliability and validity of the EBP Beliefs and Implementation Scales in a heterogeneous sample of practicing nurses. EVIDENCE TO ACTION: Use of the scales in future research could generate evidence to guide EBP implementation strategies in practice and education. Results could establish the extent to which EBP is being implemented and its effect on clinician satisfaction and patient outcomes.

Back to the Future: Personal Digital Assistants in Nursing Education

This article provides an overview of the current state of the art for incorporating personal digital assistants (PDAs) into nursing education. The development of PDA technology and the lessons learned by educators integrating PDA technology into nursing curricula are described. The current cycle of PDA evolution is discussed and contrasted with a proposed model for maximizing the impact of PDAs on technological innovation in nursing education and practice.

The relationship of perceived and actual weight in minority adolescents.

The prevalence of overweight in adolescents with its associated outcomes continues to be a major public health concern. The purpose of this study was to assess whether adolescents perceived their weight accurately and to determine the relationships among perceived and actual weight, depression, anxiety, anger, disruptive behavior, and self-concept in minority adolescents. A descriptive, correlational design was conducted with 33 adolescents. Questions regarding weight perception, depression, anxiety, anger, disruptive behavior, and self-concept were correlated with body fat percentile, body mass index (BMI), and BMI percentile. Findings indicated that adolescent perception of overweight was positively related to actual weight and negatively related to self-esteem and disruptive behavior. Adolescents who were overweight identified their weight accurately and tried to lose weight.