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Biomedical Literacy in the United States: Exploring the borderland between science and citizenship
Unformatted Document Text:  4 Communication researchers speak of a knowledge gap, in which better educated segments of the population make more effective use of new information and new information sources, often widening the gap in knowledge (Donohue, Olien, and Tichenor, 1987; Donohue, Tichenor, and Olien, 1975; Severin and Tankard, 1992). As a result of differential use of information, public health campaigns may simultaneously increase the level of understanding of better educated citizens and create a greater disparity in knowledge between the best and worst informed citizens. A set of confirmatory factor analyses of a series of national studies in the United States and the European Union 1 throughout the 1990’s found that the two dimensions described above were closely correlated for biomedical literacy and could be represented by a single factor (Miller, Pardo, and Niwa, 1997; Miller and Pardo, 2000). A set of 24 biomedical knowledge items from seven national U.S. studies and two Eurobarometers provided a solid data base, and item-response-theory (IRT) techniques were used to derive a cross-national measure of biomedical literacy for the United States and the European Union for the period from 1988 through 1999 (Zimowski et.al., 1996). For this analysis, which will use only the 1999 U.S. Science and Engineering Indicators study, biomedical literacy is estimated on the basis of nine items, using the IRT metric from the U.S.-E.U. studies (see Table 1). The items included range from an open-ended definition of DNA to an agree-disagree question about antibiotics. The mean score on the Index of Biomedical Literacy increased from 44.7 in 1988 to 51.1 in 1999 in the U.S. The percent of Americans able to score 70 or more on this Index increased from 11 percent in 1988 to 19 percent in 1999 (see Figure 1). 1 The measures of biomedical literacy in the United States use seven data sets collected over an 11 year period. Five of the surveys are studies for the National Science Board’s Science and Engineering Indicators reports in 1988, 1990, 1995, 1997, and 1999 (NSB, 1989, 1991, 1996, 1998, 2000). Each of the surveys was based on a national probability sample of approximately 2000 adults aged 18 and older, was conducted by telephone, and included a common core of knowledge items described in the measurement section below. The response rate for all five surveys was approximately 70 percent. The NSB Indicators series were supplemented by two additional national studies. In 1993, the National Institutes of Health sponsored a national survey of approximately 3,100 adults to measure biomedical literacy. This survey repeated many of the core knowledge items used in previous NSB studies and expanded the set of biomedical knowledge items. In 1997-98, the National Science Foundation supported a national study of adult understanding of and attitudes toward biotechnology in the United States, designed to parallel a 1996 European Union study.

Authors: Miller, Jon. and Kimmel, Linda.
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4
Communication researchers speak of a knowledge gap, in which better educated segments of the
population make more effective use of new information and new information sources, often widening the
gap in knowledge (Donohue, Olien, and Tichenor, 1987; Donohue, Tichenor, and Olien, 1975; Severin
and Tankard, 1992). As a result of differential use of information, public health campaigns may
simultaneously increase the level of understanding of better educated citizens and create a greater
disparity in knowledge between the best and worst informed citizens.
A set of confirmatory factor analyses of a series of national studies in the United States and the
European Union
1
throughout the 1990’s found that the two dimensions described above were closely
correlated for biomedical literacy and could be represented by a single factor (Miller, Pardo, and Niwa,
1997; Miller and Pardo, 2000). A set of 24 biomedical knowledge items from seven national U.S. studies
and two Eurobarometers provided a solid data base, and item-response-theory (IRT) techniques were used
to derive a cross-national measure of biomedical literacy for the United States and the European Union
for the period from 1988 through 1999 (Zimowski et.al., 1996). For this analysis, which will use only the
1999 U.S. Science and Engineering Indicators study, biomedical literacy is estimated on the basis of nine
items, using the IRT metric from the U.S.-E.U. studies (see Table 1). The items included range from an
open-ended definition of DNA to an agree-disagree question about antibiotics. The mean score on the
Index of Biomedical Literacy increased from 44.7 in 1988 to 51.1 in 1999 in the U.S. The percent of
Americans able to score 70 or more on this Index increased from 11 percent in 1988 to 19 percent in 1999
(see Figure 1).
1
The measures of biomedical literacy in the United States use seven data sets collected over an 11 year period. Five
of the surveys are studies for the National Science Board’s Science and Engineering Indicators reports in 1988,
1990, 1995, 1997, and 1999 (NSB, 1989, 1991, 1996, 1998, 2000). Each of the surveys was based on a national
probability sample of approximately 2000 adults aged 18 and older, was conducted by telephone, and included a
common core of knowledge items described in the measurement section below. The response rate for all five
surveys was approximately 70 percent. The NSB Indicators series were supplemented by two additional national
studies. In 1993, the National Institutes of Health sponsored a national survey of approximately 3,100 adults to
measure biomedical literacy. This survey repeated many of the core knowledge items used in previous NSB
studies and expanded the set of biomedical knowledge items. In 1997-98, the National Science Foundation
supported a national study of adult understanding of and attitudes toward biotechnology in the United States,
designed to parallel a 1996 European Union study.


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