Addressing the "other" health literacy competencies--knowledge, dispositions, and oral/aural communication: development of TALKDOC, an intervention assessment tool.

Most health literacy assessments evaluate literacy skills including reading, writing; numeracy and interpretation of tables, graphs, diagrams and charts. Some assess understanding of health systems, and the ability to adequately apply one's skills to specific health-related tasks or demands in health situations. However, to achieve functional health literacy, the ability to "obtain, process, and understand basic health information and services needed to make appropriate health decisions," other health literacy dimensions should be assessed: a person's knowledge and attitudes about a health issue affects his or her ability to and interest in participating in his or her own care. In patient care settings, the abilities to listen, ask questions and check one's understanding are crucial to making appropriate decisions and carrying out instructions. Although literacy is a skill associated with educational attainment and therefore difficult to change in a short time, health education interventions can address health literacy domains such as knowledge, attitudes and oral communication skills. For this reason, an instrument that can assess these constructs is a valuable part of a health educator's toolbox. The authors describe the development and process and outcomes of testing a novel instrument targeted to assess HPV and cervical cancer health literacy competencies, TALKDOC, including its validation with the Health Activities Literacy Scale.

Evaluation for community-based programs: the integration of logic models and factor analysis.

PURPOSE: To discuss the utility of and value of the use of logic models for program evaluation of community-based programs and more specifically, the integration of logic models and factor analysis to develop and revise a survey as part of an effective evaluation plan. PRINCIPAL RESULTS: Diverse stakeholders with varying outlooks used a logic model as a framework to reach agreement on a plan for a state-wide evaluation. This evaluation plan utilized a survey of sixth grade students, administered before and after exposure to a year-long abstinence education program. Components of the logic model were linked to specific survey questions. Exploratory factor analysis was then used to assess whether and how the questions in the survey fit with the constructs of the model; confirmatory factor analysis was used to test the hypothesis that the factors identified in the exploratory analysis were consistently represented in the survey. MAJOR CONCLUSIONS: A logic model is a tool that engages stakeholders to link evaluation instruments more closely to specific program objectives. Thus, stakeholders can more closely assess the extent to which project outcomes have been achieved. In addition, use of factor analysis in the evaluation process can help the stakeholders better understand whether evaluation instruments such as a survey adequately assess program effectiveness. Lastly, a logic model process can help to achieve consensus among diverse stakeholders, by allowing them to focus on objectives that are concrete, measurable, and mutually acceptable.