The Newest Vital Sign© (NVS) was developed in the USA to measure patient health literacy in clinical settings. We adapted the NVS for use in Canada, in English and French, and created a computerized version. Our objective was to evaluate the reliability of the Canadian NVS as a self-administered computerized tool.

We used a randomized crossover design with a washout period of 3–4 weeks to compare health literacy scores obtained using the computerized version with scores obtained using the standard interviewer-administered NVS. ANOVA models and McNemar’s tests assessed differences in outcomes assessed with each version of the NVS and order effects of the testing.

Participants were recruited from multicultural catchment areas in Ontario and Nova Scotia.

English- and French-speaking adults aged 18 years or older.

A total of 180 (81 %) of the 222 adults (112 English/110 French) initially recruited completed both the interviewer-NVS and computer-NVS. Scores for those who completed both assessments ranged from 0 to 6 with a mean of 3·63 (sd 2·11) for the computerized NVS and 3·41 (sd 2·21) for the interview-administered NVS. Few (n 18; seven English, eleven French) participants’ health literacy assessments differed between the two versions.

Overall, the computerized Canadian NVS performed as well as the interviewer-administered version for assessing health literacy levels of English- and French-speaking participants. This Canadian adaptation of the NVS provides Canadian researchers and public health practitioners with an easily administered health literacy assessment tool that can be used to address the needs of Canadians across health literacy levels and ultimately improve health outcomes.

The present work aimed at cross-cultural adaptation and validation of the health literacy assessment tool Newest Vital Sign (NVS) in general population (GP) and highly educated (HE) samples of Brazilian adults.

An expert committee reviewed the translation and back-translation processes and the cultural adaptation. The construct validity was analysed with confirmatory factor analysis and via associations with features of the study population.

The final validation test was performed in two different populations from Londrina, a large town in southern Brazil.

Brazilian adults: GP (adult clients of community pharmacies; n 189) and HE (public school teachers; n 301).

The tool under validation showed good cross-cultural adaptation and internal consistency, with Cronbach’s α of 0·75 for GP and 0·74 for HE. Confirmatory factor analysis showed acceptable models and identified two independent factors according to the relationship between components and numeracy for both GP and HE data. According to the Brazilian Portuguese version of the NVS instrument (NVS-BR), 48·7 % of GP and 33·5 % of HE presented adequate health literacy; this condition was inversely associated with age for both populations and directly correlated with educational level for GP.

The NVS-BR showed good validity in two different populations of Brazilian adults and can be considered an alternative in screening for inadequate health literacy.