Development of the Verbal Exchange Health Literacy Measure Project Summary/Abstract The proposed research addresses a gap in our understanding of functional health literacy assessment. Health literacy is defined as the ability to obtain, process, and use health related information in informed health related care decisions. The Institute of Medicine discusses "print literacy," "oral literacy" and "numeracy" as the basic components of health literacy. "Oral literacy" refers to listening and speaking or what we term verbal-exchange health literacy. This includes patient understanding of spoken medical advice or treatment directions as well as articulating symptoms and questions. Yet, in health research, health literacy measures are limited to the classification of patient reading ability, word recognition and/or number use. The overall objective of the proposed study is to develop a multi-item measure for the assessment of functional verbal-exchange health literacy. Although the majority of health encounters are based on spoken communication, current measures of health literacy do not capture this specific construct of functional health literacy. The project aims to 1) identify the salient functional health literacy issues in the verbal exchange of health information from the patient perspective and 2) develop a multi-item measure of functional health literacy for verbal communication. The proposed study utilizes a multi-step strategy to develop the Verbal Exchange Health Literacy Measure in two sites: southeast Michigan (Ann Arbor, Detroit and Ypsilanti, MI) and Birmingham, Alabama. Perceptions will be elicited from patients recruited from community clinics (including FHQCs) and representing the adult life span. As well, a panel of experts in communication, linguistics, measurement design, and health literacy will provide expertise in this endeavor. Expanding the understanding of verbal exchange health literacy's impact on health outcomes has important implications for addressing health disparities in high risk populations. PUBLIC HEALTH RELEVANCE: The majority of health communications between patient and practitioners are delivered by verbal communication - exchange. Missing from current measures of functional health literacy is the assessment of understanding and articulation of information exchanged through verbal communication. This study will develop a measure for the assessment of functional verbal-exchange health literacy following strict methodological procedures for the identification of salient verbal health literacy issues in the exchange of health information between patients and providers and the development of a multi-item measure of functional verbal-exchange health literacy.