College of Public Health and Human Sciences

This study examines the role of computational and Nutrition Facts Label (NFL) skills in health literacy classifications using the Newest Vital Sign (NVS). A convenience sample of 144 SNAP-eligible adults was given an original and modified version of the NVS. Responses on NVS and modified NVS (NVS-M) were compared using a paired McNemar test, while the order of administration was evaluated using a chi-square test. Overall, significant differences between the paired NVS and NVS-M responses (p < 0.001) resulted in more classifications of adequate health literacy with the NVS-M. Stratification by order of administration revealed a version-specific priming effect, but a comparison of the first administration of each assessment showed no significant difference in classifications (p = 0.955). Common incorrect responses reflected computational errors and confounding serving size and servings per container. Nutrition education may improve NFL skills, while limited numeracy may undermine their utility. Differentiation among related health literacy concepts could improve measurement and screening.