Using the Short Graph Literacy Scale to Predict Precursors of Health Behavior Change

Yasmina Okan, Eva Janssen, Mirta Galesic, Erika A. Waters

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background. Visual displays can facilitate risk communication and promote better health choices. Their effectiveness in improving risk comprehension is influenced by graph literacy. However, the construct of graph literacy is still insufficiently understood, partially because existing objective measures of graph literacy are either too difficult or too long. Objectives. We constructed a new 4-item Short Graph Literacy (SGL) scale and examined how SGL scores relate to key cognitive, affective, and conative precursors of health behavior change described in common health behavior theories. Methods. We performed secondary analyses to adapt the SGL scale from an existing 13-item scale. The initial construction was based on data collected in a laboratory setting in Germany (n = 51). The scale was then validated using data from nationally representative samples in Germany (n = 495) and the United States (n = 492). To examine how SGL scores relate to precursors of health behavior change, we performed secondary analyses of a third study involving a nationwide US sample with 47% participants belonging to racial/ethnic minorities and 46% with limited formal education (n = 835). Results. Graph literacy was significantly associated with cognitive precursors in theoretically expected ways (e.g., positive associations with risk comprehension and response efficacy and a negative association with cognitive risk perception). Patterns for affective precursors generally mirrored those for cognitive precursors, although numeracy was a stronger predictor than graph literacy for some affective factors (e.g., feelings of risk). Graph literacy had predictive value for most cognitive and affective precursors beyond numeracy. In addition, graph literacy (but not numeracy) predicted key conative precursors such as defensive processing. Conclusions. Our data suggest that the SGL scale is a fast and psychometrically valid method for measuring objective graph literacy. Our findings also highlight the theoretical and practical relevance of graph literacy.

Original languageEnglish
Pages (from-to)183-195
Number of pages13
JournalMedical Decision Making
Issue number3
StatePublished - Apr 1 2019


  • graph literacy
  • health behavior
  • individual differences
  • risk communication
  • risk perception
  • visual aids


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