A shortened instrument for literacy screening

J Gen Intern Med. 2003 Dec;18(12):1036-8. doi: 10.1111/j.1525-1497.2003.10651.x.


The Rapid Estimate of Adult Literacy in Medicine (REALM-R), a new 8-item instrument designed to rapidly screen patients for potential health literacy problems, was administered to 157 patients. The REALM-R was correlated with Wide Range Achievement Test-Revised (WRAT-R) (.64) and demonstrated a Cronbach's alpha of 0.91. The REALM-R identified 26 of 30 persons scoring more than 1 standard deviation below the mean on the WRAT-R, corresponding to a sixth grade reading level. The REALM-R identified a substantial number of people who scored poorly on the WRAT-R, and depending on further studies of validity and reliability, may offer a practical approach to identify patients at risk for health literacy problems in a clinical setting.

MeSH terms

  • Educational Status*
  • Humans
  • Kentucky
  • Mass Screening / methods*
  • Pilot Projects
  • Reading*
  • Statistics, Nonparametric