Purpose: Testing client's ability to read and to comprehend written health care instructions is becoming more widespread. Current health literacy screening instrument for health care are developed by Western community and available only in English. Purpose of the study was to develop a short and accurate screening test of limited health literacy for Korean older adults.

Method: We developed orignial 83 candidate items which included 66 medical terms, 10 reading comprehension items, 7 numeracy items based on review of the literature, existing health education materials, and literacy instruments. The items were reviewed and revised seveal times by an expert panel. Content validity was assessed by 10 health and nursing experts. Survey was performed to assess construct validity, criterion validity, and reliability (Internal consistency and test-retest reliability) using a sample of 300 elderly persons living in community.

Results: We measured content validity using content validity index (CVI) and final 46 items were chosen. Factor analysis was performed to assess construct validity and criterion validity was assessed by measuring correlations with REALM scores. We also evaluated test-retest reliability and internal consistency as reliability measures.

Conclusion: Health Literacy Scale which was developed in this study is culturally suitable for screening test for limited literacy for Korean elderly in the community.