The numeracy section of the TOFHLA measures the patient’s ability to understand and act on numerical directions given by a health-care provider or pharmacist. The test items reproduce real-life situations in receiving, following, and paying for medication plans. The numeracy section uses a series of prompts to which the patient responds. These prompts consist of prescription vials, an appointment slip, a chart describing eligibility for financial aid, and an example of results from a medical test. The patient is handed the prompt for each question, the administrator reads each question, and the responses are recorded.

At the beginning of this section, the following introduction is read: “These are directions you or someone else might be given at the hospital. Please read each direction to yourself. Then I will ask you some questions about what it means.” For the first few questions in this section the patient is given Prompt 1, a prescription bottle that has the label shown in Figure C-1 below taped to it.

Front Matter (R1-R20)

Executive Summary (1-18)

1 Introduction (19-30)

2 What Is Health Literacy? (31-58)

3 Extent and Associations of Limited Health Literacy (59-107)

4 Culture and Society (108-141)

5 Educational Systems (142-166)

6 Health Systems (167-239)

7 Vision for a Health Literate America (240-242)

Appendix A: Data Sources and Methods (243-254)

Appendix B: Commissioned Papers (255-300)

Appendix C: Sample Material from Selected Assessments of Literacy and Health Literacy (301-322)

Appendix D: Committee and Staff Biographies (323-330)

Index (331-346)