Downloaded By: [Donaghy, Maryann] At: 20:06 17 December 2007 Patients’ Shame and Attitudes Toward Discussing the Results of Literacy Screening MICHAEL S. WOLF Health Literacy and Learning Program, Division of General Internal Medicine, Northwestern University, Chicago, Illinois, USA MARK V. WILLIAMS AND RUTH M. PARKER Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA NINA S. PARIKH Center for Health and Public Service Research, Robert F. Wagner Graduate School of Public Service, New York University, New York, New York, USA ADAM W. NOWLAN Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA DAVID W. BAKER Division of General Internal Medicine and Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA We investigated patients’ willingness to have their reading ability documented in their medical records and the degree of shame and embarrassment associated with such disclosure. Structured interviews were conducted among a consecutive sample of 283 primary care patients at an urban public hospital. Patients’ literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM). Self- report of degree of shame and embarrassment related to literacy skills was measured using an orally administered questionnaire. Fifty-one percent of patients had low lit- eracy skills (  sixth grade) and 27.9% were assessed as having marginal literacy (seventh–eighth grade). Half (47.6%) of patients reading at or below the third- grade level admitted feeling ashamed or embarrassed about their difficulties reading, compared with 19.2% of those reading at the fourth–sixth-grade level and 6.5% of those reading at the seventh–eighth-grade level (p < 0.001). More than 90% of patients with low or marginal literacy reported it would be helpful for the doctor Dr. Wolf is supported by a Centers for Disease Control and Prevention Career Develop- ment Award (K01 EH000067-01). Address correspondence to Michael S. Wolf, Health Literacy and Learning Program, Division of General Internal Medicine, Northwestern University, 676 N. St. Clair Street, Suite 200, Chicago, IL 60611, USA. E-mail: mswolf@northwestern.edu Journal of Health Communication, 12:721–732, 2007 Copyright # Taylor & Francis Group, LLC ISSN: 1081-0730 print/1087-0415 online DOI: 10.1080/10810730701672173 721