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The Newest Vital Sign

A Health Literacy Assessment Tool for Patient Care and Research

The Newest Vital Sign (NVS) is a valid and reliable screening tool available in English and Spanish that identifies patients at risk for low health literacy. It is easy and quick to administer, requiring just three minutes. In clinical settings, the test allows providers to appropriately adapt their communication practices to the patient’s health literacy level. Researchers have used the instrument to measure health literacy and evaluate the impact of low health literacy on a variety of health outcomes.

The Newest Vital Sign is one of Pfizer Inc.’s most important contributions to the health literacy movement and has been researched extensively by health literacy experts. In a recent systematic review1, the NVS performed moderately well in identifying patients with limited literacy.

How Does the Newest Vital Sign Work?

The Newest Vital Sign is based on a nutrition label from an ice cream container. Patients are given the label and then asked 6 questions about it. Patients can and should refer to the label while answering questions. The questions are asked orally and the responses recorded by a health care provider or researcher on a special score sheet, which contains the correct answers. Based on the number of correct responses, the health care provider or researcher can assess the patient’s health literacy level.

What Can Providers Do to Improve Patient Understanding?

If the Newest Vital Sign results indicate a patient has limited health literacy skills, providers can use clear health communication techniques to help patients better understand their medical issues and follow instructions. Additional resources are available on these techniques and their role in medication safety.

What Research Supports the Newest Vital Sign?

Since the Newest Vital Sign was published in the Annals of Family Medicine (December 2005), it has appeared in more than 25 peer-reviewed studies. The NVS has been used to assess health literacy in populations ranging from parents of young children to older adults, among racial/ethnic minorities, and applied to a wide variety of health conditions.

Newest Vital Sign - English

Newest Vital Sign - Spanish


1Powers BJ, et al. Can this patient read and understand written health information? JAMA 2010 Jul 7;304(1):76-84