The study of 102 adolescent females at a central city clinic in Milwaukee was done with Children's Hospital of Wisconsin, a major affiliate.

"High-risk adolescents, who need information the most, may be unable to read and understand basic instructions given in materials on contraceptive use, sexually transmitted diseases, or administering medication to their children" says Steven C. Matson, M.D., associate professor of pediatrics. He and Medical College nurse practitioner Kristin A. Haglund were co-authors of the study.

Study participants ages 12-20 completed an oral questionnaire that requested demographic and other information on their scholastic history, sexual behavior and substance abuse.

More than 90 percent were African-American and six percent were Hispanic. Each also completed the Accuracy Level Test (ALT), a 10-minute timed reading test.

The reading grade level achieved on the test is subtracted from the girl's age-appropriate grade in school to provide a reading delay level (RDL). The RDL helps identify those falling behind their peers in reading.

On average, study participants read at a level of two to seven grades lower than their age would indicate. Not surprisingly, students who did not attend school often or who repeated grades had more significant reading delays.

Previously pregnant students had even greater reading level delays than those who did not often attend school.

The study concludes that the ALT may be a quick and effective way to identify high-risk patients who need more intensive clinical intervention for success in prevention and treatment efforts, and suggests that it become a standard part of new patient visits.

Of the study participants, 84 percent attended school regularly, and 43 percent had repeated at least one grade. Only 14 percent reported alcohol use and 13 percent admitted smoking cigarettes. Marijuana use was reported by 38 percent.

Participants also reported a high rate of sexual activity (86 percent) with the average age of onset ranging from 12.8 to 15.8 years. Nearly half had been pregnant at least once, and 30 percent of the sexually active reported no condom use. Neither substance abuse nor condom use, however, were predictors of reading level.

Earlier studies have shown that illiteracy may influence health. They've found that patients with higher literacy skills are more likely to follow the instructions of health care providers, to keep chronic care appointments, and to contact a provider early in an illness.

Other studies have revealed that as many as 50 percent of adult patients are unable to understand the instructions on a medication bottle. - By Eileen La Susa

[Contact: Eileen La Susa ]

06-Oct-2000