At the end of the numeracy section, the patient is given Prompt 10, a laminated card with information shown in Figure C-2 below.

FIGURE C-2 Prompt 10 for TOFHLA. Laminated card with financial information about clinic services.

Question for Prompt 10:

Let’s say that after deductions, your monthly income and other resources are $1,129. And, let’s say you have 3 children. Would you have to pay for your care at that clinic?

Reading Comprehension

The reading comprehension section of the TOFHLA measures a patient’s ability to read passages using real materials from the health-care setting using a modified Cloze procedure. Passages included come from instructions for preparation for an upper GI series, the patient rights and responsibilities section of a Medicaid application form, and standard hospital informed consent language.

Sample Items

At the beginning of the reading comprehension section of the TOFHLA, the following instructions are read:

Here are some other medical instructions that you or anybody might see around the hospital. These instructions are in sentences that have some of the words missing. Where a word is missing, a blank line is drawn, and 4 possible words that could go in the blank appear just below it. I want you to figure out which of those 4 words should go in the blank, which word makes the sentence make sense. When you think you know which one it is, circle the letter in front of that word, and go on to the next one. When you finish the page, turn the page, and keep going until you finish all the pages.

The reading comprehension section consists of three passages; one of these passages is shown on the next page.

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