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(PTFS11-05-26) Measuring Nutrition Literacy in Adults: A Systematic Review and Appraisal of Current Measurement Tools

Monday, July 27, 2026
8:16 AM - 8:20 AM ET
Location: Prince George's Hall B-E (The Hub) - Poster Theater 2 / Poster Board Number: PT2-5
Disclosure(s):
Aubree L. Hawley, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Selorm S. Attu, MPhil: No relevant financial relationship(s) with ineligible companies to disclose.
Sydney E. Boudrey, MS, RD: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Despite increasing interest in nutrition literacy (NL), measurement approaches vary considerably in theoretical grounding and domain coverage. The objective of this systematic review was to evaluate adult NL assessment instruments and examine the extent to which they comprehensively capture functional, interactive, and critical domains using an internally developed NL Framework model after Nutbeam’s Model of Health Literacy.

Methods: This systematic review was conducted in accordance with PRISMA guidelines. PubMed, MEDLINE (EBSCO), Web of Science, Cochrane Library, and Google Scholar were searched for studies describing the development, validation, or application of adult NL assessment instruments. Eligible studies included peer-reviewed publications of original tools administered to adults aged ≥18 years. Two reviewers independently screened titles, abstracts, and full texts, with disagreements resolved by a third reviewer. Instruments were evaluated using an internally developed NL Framework grounded in functional, interactive, and critical domains. Each tool was examined to which key domains of NL were included and for psychometric properties.

Results: The search identified 1,687 papers, of which 1,239 remained after removal of 448 duplicates and were screened for eligibility. Thirty NL measurement tools met inclusion criteria, including seven developed in the United States. Twenty-three tools assessed functional NL, emphasizing knowledge, reading comprehension, numeracy, or familiarity with dietary guidelines. Interactive and critical domains appeared in 8 and 10 tools, respectively. Seven tools, and only one applicable to US populations, albeit in college students, assessed at least one aspect of functional, interactive, and critical NL. Psychometric properties varied considerably across tools, with 10 reporting content and face validity, 9 reporting model fit indices, and 18 reporting internal consistency.

Conclusions: Multidimensional, psychometrically sound tools that comprehensively assess NL domains are needed, particularly for adults living in the United States.

Funding Sources: This study was funded by the USDA National Institute of Food and Agriculture, Agriculture and Food Research Initiative, Grant No. 2023-68015-39408.