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Authors: Joanne R. Nurss, Ph.D.
Ruth M. Parker, M.D.
Mark V. Williams. M.D.
David W. Baker, M.D., M.P.H.

TOFHLA is used to measure functional health literacy--both numeracy and reading comprehension--using actual health-related materials such as prescription bottle labels and appointment slips. It is designed to assess adult literacy in the health care setting:

by health care providers, to determine the adequacy of their patients' reading and understanding of health care materials needed for their health care or health education;
by researchers, to assess patient health literacy as a variable in their research.

TOFHLA was developed at Georgia State University under a grant to Emory University from the Robert Wood Johnson Foundation and was first published in 1995. It is now available from Peppercorn Books.

TOFHLA is presented in a three ring notebook for ease of use. You may photocopy the instruments for use in your own research or testing, within your department or organization only. The TOFHLA package includes:

Full versions in English and Spanish, in regular (12 pt.) and large font (14 pt).
A short version in English and Spanish in large font (14 pt).
Directions for administration and scoring and the technical manual for each.
A bibliography of published articles concerning the development and validation of the instrument and research studies for using it.

View sample pages here (in PDF format).

See more details



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