The Institute’s Report records important work done
mostly in the US on the development of health literacy
measurement tools and ‘‘screening aids’’ for clinicians such
as the Rapid Estimate of Adult Literacy in Medicine
(REALM) (Davis et al., 1993) or the Test of Functional Health
Literacy in Adults (TOFHLA) (Parker, Baker, Williams, &
Nurss, 1995). It also describes the state of the science of
health literacy and its association with a range of health
practices and outcomes, especially effective management
of chronic disease, compliance with medication and other
health advice, and participation in health and screening
programs.