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Author Notes:

R.L. Ownby: Room 1477, 3200 South University Drive, Fort Lauderdale, FL 33314, USA. Tel.: +1 954 262 1481. ro71@nova.edu

The authors also acknowledge other members of the team of investigators: Drs. Sara J. Czaja and David Loewenstein (Center on Aging at the University of Miami Miller School of Medicine); Rosemary Davenport, RN, MSN, ARNP, Study Coordinator; Dr. Ana-Maria Homs, Assessor; and Ms. Lilly Valiente who provided data management assistance.

The authors state that they have no conflict of interest in the study.


Research Funding:

This study was supported by a grant to Dr. Ownby from the US National Heart, Lung, and Blood Institute (R01HL096578).


  • Science & Technology
  • Social Sciences
  • Life Sciences & Biomedicine
  • Public, Environmental & Occupational Health
  • Social Sciences, Interdisciplinary
  • Social Sciences - Other Topics
  • Health literacy
  • Cognition
  • Crystallized abilities
  • Fluid abilities
  • CARE

Abilities, skills and knowledge in measures of health literacy


Journal Title:

Patient Education and Counseling


Volume 95, Number 2


, Pages 211-217

Type of Work:

Article | Post-print: After Peer Review


Objective: Health literacy has been recognized as an important factor in patients' health status and outcomes, but the relative contribution of demographic variables, cognitive abilities, academic skills, and health knowledge to performance on tests of health literacy has not been as extensively explored. The purpose of this paper is to propose a model of health literacy as a composite of cognitive abilities, academic skills, and health knowledge (ASK model) and test its relation to measures of health literacy in a model that first takes demographic variables into account. Methods: A battery of cognitive, academic achievement, health knowledge and health literacy measures was administered to 359 Spanish- and English-speaking community-dwelling volunteers. The relations of health literacy tests to the model were evaluated using regression models. Results: Each health literacy test was related to elements of the model but variability existed across measures. Conclusion: Analyses partially support the ASK model defining health literacy as a composite of abilities, skills, and knowledge, although the relations of commonly used health literacy measures to each element of the model varied widely. Practice implications: Results suggest that clinicians and researchers should be aware of the abilities and skills assessed by health literacy measures when choosing a measure.

Copyright information:

© 2014 Elsevier Ireland Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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