Visit the NEW

Health Literacy Toolshed!


This website helps you:

  1. Learn about health literacy measurement tools
  2. Find tools that meet your needs

Inclusion Criteria

At this time, this website only includes tools (health literacy measures, instruments, and items) that:

  1. Are published in peer-reviewed journals, which describe the measure and its development process.
  2. Were published prior to January 2014. We are planning to add more over time.
  3. Measure an individual’s health literacy. Some of the health literacy tools that are not included assess the complexity of the health care system, provider communication skills, or other facets of organizations or materials.

The available tools to assess an individual’s health literacy proliferated during the past decade. While there are more than 100 tools available on this site, dozens more have yet to be added. Please let us know if you have suggestions to improve the Tool Shed, such as tools to be added or additional information on the listed measures. Please use the Contact Us web form. Michael Paasche-Orlow, MD, MA, MPH, the lead academic partner for this project, will incorporate your suggestions in future site updates.

Current Limitations and Considerations in Tool Selection

Instrument validation is an ongoing process. The Tool Shed includes the most common type of validation information available in research published to date. However, before selecting a tool, we suggest you contact the author(s) of the tool (identified in the Tool Shed), or read the full paper and contact the corresponding author.

Authors: If your contact information is inaccurate or is not listed, please send us your current contact information so others can reach out to you. This helps everyone learn from — and expand on — your work.

When selecting a tool for your project, please keep these limitations in mind:

  1. Despite the overall large number of tools, there may be only a few instruments to assess some of health literacy’s conceptual domains. Similarly, some health literacy domains are assessed by a few (or sometimes only one) item.
  2. The validation evidence presented for multiple tools focuses on concurrent validity, which is commonly reported in journals. Construct validity is less frequently reported. The prominence of a few measures as the basis of concurrent validity (i.e., TOFHLA and REALM) has led to something of an interdependent validation churn.
  3. While tools (measures) based upon self-reports are easier to administer, they lack firm empirical grounding. For example, some participants do not have accurate insight about their own skill level. Accordingly, user caution is suggested when using such tools to assess individual care or services. Also, while contemporary test item and scale development methods remedy some of the problems inherent in classical test theory, only a small but growing number of tools are based on these methods. To view these tools, please filter the list by ‘Modern Approach for Tool Development.’

Opportunities for Future Research

In developing the Tool Shed, we found gaps within some health literacy measures. We suggest future researchers close these gaps by:

  1. Aligning health literacy measurement with theory and conceptual models
  2. Developing methods of objective measurement that approximate the convenience of self-report measures
  3. Conducting comparative assessment of self-reported and objective measures

About the Health Literacy Tool Shed Team

This project is a collaboration among:

  1. CommunicateHealth, Inc.
  2. Boston University (Lead contact: Michael Paasche-Orlow, MD, MA, MPH)
  3. RTI International (Lead contact: Lauren McCormack, PhD, MSPH)

Funding is provided by the National Institutes of Health’s National Library of Medicine (Lead contact: Robert A. Logan, PhD).

October 30, 2015
Primary teaching affiliate
of BU School of Medicine