Health Literacy Assessment Using Talking Touchscreen Technology (Health LiTT) is a novel approach to measurement of health literacy.


Health LiTT defines health literacy as “the degree to which individuals have the capacity to read and comprehend health-related print material, identify and interpret information presented in graphical format (charts, graphs, tables), and perform arithmetic operations in order to make appropriate health and care decisions” (Yost et al., 2009, p.298) . This definition encompasses an individual’s capacity to process and understand health-related information, and the ability to apply that information in the management of her/his own health. The capacity to obtain information, which is part of previous definitions (Nielsen-Bohlman et al., 2004) is a navigation skill that requires a different measurement tool.

Available measures:




  • 14-item short form
  • 90 items currently being tested


 Why was this developed?
A critical review of existing health literacy instruments found inconsistencies in the definition and measurement of health literacy, limited empirical evidence of construct validity, and weaknesses in their psychometric properties (Jordan et al., 2010).

  • Health LiTT was developed to enable more precise and reliable estimation of health literacy.
  • Health LiTT is designed as a self-administered multimedia touchscreen test of health literacy.
  • Three item types are used to measure a single dimension of health literacy.
  • Prose item: a brief text passage of health-related information (approximately 40-60 words) followed by a single-sentence comprehension item with a missing word
  • Document item: an image (table, graph, prescription label) is presented and a question asks about information that can be located in the image
  • Quantitative item: a question that requires some type of arithmetic computation to determine the correct answer; some quantitative items also have an image
  • Each item uses a multiple-choice format with one correct answer.
  • Some items have an image.
  • The questions for document and quantitative items have text and sound.