As health literacy started to become recognized as a priority by health authorities and governments worldwide ( Carmona, 2006), studies in health literacy, both empirical and conceptual, have also been increasingly appearing outside the US, where the field originated ( Paasche-Orlow, 2009 Pleasant, 2012). Several studies found health literacy to be an important predictor of people’s health status and other health outcomes ( Dewalt et al., 2004), adherence to official health-related recommendations ( Zhang et al., 2014), and medical expenditures ( Howard et al., 2005). Health literacy, defined as ‘the personal, cognitive and social skills which determine the ability of individuals to gain access to, understand, and use information to promote and maintain good health’ ( Nutbeam, 2000), has continued to receive increasing attention as a research field for the past 20 years ( Ishikawa and Yano, 2008 Peerson and Saunders, 2009 Pleasant, 2012 Sörensen et al., 2012). Health literacy, Arabic, S-TOFHLA, REALM-R, brief health literacy screening items INTRODUCTION Results indicate that the S-TOFHLA and the three screening questions are a valuable tool to measure health literacy in Lebanon and, allowing for minimal adaptations according to each country’s healthcare system, in the entire Arabic-speaking area. The Brief Health Literacy Screening items were significantly correlated with age, education, self-efficacy and the S-TOFHLA, reinforcing the convergent and predictive validity of the two tools. Younger and highly educated participants scored higher on the S-TOFHLA. Reliability of the instruments was found to be low to high (Cronbach’s α =0 .94 for the S-TOFHLA, Cronbach’s α = 0.46 for the REALM-R). The General Self-Efficacy Scale and socio-demographic questions such as gender, age, origin, education and chronic condition were included to assess predictive validity. The tools were linguistically and culturally adapted to the Lebanese context, and 250 face-to-face interviews were conducted in an outpatient clinic in Beirut, Lebanon, between April and June 2015. The aim of this study was to validate Arabic translations of three commonly used health literacy assessment tools, the S-TOFHLA, the REALM-R, and the Brief Health Literacy Screening items.

However, research on health literacy in the Arab world is scarce and no health literacy tool has been validated to test the health literacy level of the Lebanese population so far. Health literacy is an important predictor of health status, health behaviours, and other health outcomes.

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