Measuring General Health Literacy in Chinese adults: validation of the HLS19-Q12 instrument
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SUBMITTER: Liu R
PROVIDER: S-EPMC11017570 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundFor improving health literacy (HL) by national and international public health policy, measuring population HL by a comprehensive instrument is needed. A short instrument, the HLS19-Q12 based on the HLS-EU-Q47, was developed, translated, applied, and validated in 17 countries in the WHO European Region.MethodsFor factorial validity/dimensionality, Cronbach alphas, confirmatory factor analysis (CFA), Rasch model (RM), and Partial Credit Model (PCM) were used. For discriminant validity, correlation analysis, and for concurrent predictive validity, linear regression analysis were carried out.ResultsThe Cronbach alpha coefficients are above 0.7. The fit indices for the single-factor CFAs indicate a good model fit. Some items show differential item functioning in certain country data sets. The regression analyses demonstrate an association of the HLS19-Q12 score with social determinants and selected consequences of HL. The HLS19-Q12 score correlates sufficiently highly (r ≥ 0.897) with the equivalent score for the HLS19-Q47 long form.ConclusionsThe HLS19-Q12, based on a comprehensive understanding of HL, shows acceptable psychometric and validity characteristics for different languages, country contexts, and methods of data collection, and is suitable for measuring HL in general, national, adult populations. There are also indications for further improvement of the instrument.
| S-EPMC9659295 | biostudies-literature
Project description:BACKGROUND:Health literacy is the ability to access to, understand, evaluate and use of essential health information to make basic health decisions. This study aimed to develop and psychometrically evaluate an instrument for measuring health literacy among adults (the Health Literacy Instrument for Adults - HELIA). METHODS:In addition to a literature review, a panel of specialists from different disciplines was formed to generate an item pool. Then, a framework was defined to develop the initial questionnaire based on a definition of health literacy and the most important global public health issues. The initial questionnaire contained 66 items. Next, 15 experts in public health were approached to assess content validity. Consequently, 19 items were removed and a provisional version of the questionnaire with 47 items was provided. Finally, a random sample of adults completed the questionnaire and psychometric properties of the instrument were assessed. RESULTS:Overall, 323 adults aged 18 to 65 years old completed the questionnaire. When the exploratory factor analysis was performed, 33 items were loaded, which indicated a 5-factor solution for the questionnaire that jointly explained 52.9% of the variance observed. The factors were as follows: access to information (6 items), reading (4 items), understanding (7 items), appraisal (4 items), and decision making/behavioral intention (12 items). Confirmatory factory analysis also indicated a good fit to the data for the five-latent structure (χ2/df = 1.60, SRMR = 0.049; RMSEA = 0.043; CFI = 0.98; NFI = 0.95; NNFI = 0.98 and GFI = 0.87). Additional analysis for internal consistency showed satisfactory results with Cronbach's alpha coefficients ranging from 0.72 to 0.89. Intraclass correlation coefficient (test-retest analysis) also showed acceptable stability for the questionnaire (ICC = 0.84). The mean score for health literacy as measured by the HELIA was 76.3 (SD = 15.1) out of 100 for the study sample. CONCLUSION:The findings suggest that the Health Literacy Instrument for Adults (HELIA) is a valid and reliable instrument for measuring health literacy. It is a short and easy-to-use instrument that could be applied in different settings.
| S-EPMC7216550 | biostudies-literature
Project description:BackgroundGeneral health literacy (general HL) affects both individual and population health on numerous levels, with low general HL leading to increased morbidity, poor health service utilization, and increased healthcare spending. This study calculated health literacy scores of a population attending specialty consultations in the community of Aragon, Spain. It further produced a sociodemographic profile and examined the relationships between patients' scores and sociodemographic variables.MethodsA sample of 150 patients from specialty consultations completed the internationally- validated HLS19-Q12 to measure adult general HL. A 4-point-Likert scale gathered information regarding 12 items of health literacy. Final scores were divided into four categorical levels: excellent, sufficient, problematic, or inadequate. Independent sample t-test, one-way ANOVA, and a generalized linear model (GLM) analysis were performed to examine key relationships with respect to sociodemographic variables and health literacy scores.ResultsThe survey was completed by 150 subjects aged 18 and over in specialty clinics in Aragon, Spain. 59% of respondents had inadequate or problematic general HL, while 41% had sufficient or excellent general HL. Income level had a significant effect on health literacy scores, F = 2.129, (p < 0.05), as did different work situations, F = 3.762, (p < 0.001). Patients who self-reported as having diabetes had a significantly higher health literacy score, t = 2.356 (p < 0.05) than those reporting other health conditions. According to GLM analysis, education, health status, income, and the number of appointments were the strongest predictors of the heath literacy score.ConclusionsGeneral HL in this patient population was limited, and lower than in some comparable studies. The sociodemographic profile constructed, and associations with health literacy established, provide policy makers, healthcare administrators, and clinicians with information to consider new policies, processes and strategies to improve general HL in this specific population.
| S-EPMC11583419 | biostudies-literature
Project description:Background/objectivesPhysical Literacy (PL) is increasingly recognized as a key element in studies aimed at promoting Physical Activity (PA), but measurement tools for emerging adults and evidence for assessing and using this concept is lacking in a wide range of contexts. We aimed to validate the French version of the Perceived Physical Literacy Instrument (PPLI): a scale for investigating PL in young French adults.MethodsAfter PL and PA data collection (n = 2,248, agemean = 19 ± 1.53 yrs), exploratory and confirmatory factor analyses, Cronbach's α and Omega's ω and an Intraclass-Correlation analysis were undertaken. Spearman's rank correlation and the Boruta algorithm were used to investigate the association between PL and PA. Boruta's algorithm examined deeper external validation by analyzing the strength of an overall PL score in explaining PA, compared with separate dimensions of PL and individual characteristics (BMI, sex).ResultsResults showed an acceptable level of reliability (ICC = 0.91), internal validity (α = 0.88; ω = 0.77), and external validity (Rhô >0.18, p < 0.01). The Boruta algorithm highlighted that the construct of PL is a significant predictor of PA, although not the strongest one which is social and affective dimension.ConclusionThis study provided data on validity and reliability of the first French assessment tool to measure PL constituted by four intertwined dimensions (physical, cognitive, social, affective). At the same time, it provides new evidence of the association between PL and PA.
| S-EPMC10373918 | biostudies-literature
Project description:BackgroundOral health literacy (OHL) is recognized as an important determinant of oral outcomes. Measuring OHL with a valid and reliable instrument that accurately captures the functional nature of this construct across cultures is needed. The short version of the Health Literacy in Dentistry scale (HeLD-14) shows promise as an appropriate instrument due to its inclusion of comprehensive domains hypothesized to comprise OHL. While studies validating the instrument in several languages have occurred, the number of dimensions in the various analyses range from one to seven. Validation of the HeLD-14 in a general English-speaking population is also lacking. The purpose of this study was to explore and confirm the dimensionality of the HeLD-14 in a general US English-speaking population.MethodsThe psychometric properties of HeLD-14 were evaluated in a sample of 631 participants attending the Minnesota State Fair. Construct validity was assessed using exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) on the data set split into two groups. Internal consistency reliability was assessed using the Cronbach's alpha coefficient. Concurrent validity was established between the HeLD-14 and the Oral Health Inventory Profile (OHIP-5) using Pearson's correlation.ResultsEFA found, and CFA reinforced, a unidimensional structure of the HeLD-14. Cronbach's alpha was acceptable at 0.92. Fit assessment also supported a unidimensional structure, comparative fit index = 0.992, Tucker-Lewis index = 0.991, root mean square error of approximation = 0.065, and standardized root mean square residual = 0.074. Concurrent validity analyses showed that the HeLD-14 correlated with the OHIP-5.ConclusionsThe HeLD-14 is a unidimensional reliable and valid instrument for measuring the oral health literacy in the general US English-speaking adult population.
| S-EPMC10573372 | biostudies-literature
Project description:BackgroundNew health care services such as smart health care and digital therapeutics have greatly expanded. To effectively use these services, digital health literacy skills, involving the use of digital devices to explore and understand health information, are important. Older adults, requiring consistent health management highlight the need for enhanced digital health literacy skills. To address this issue, it is imperative to develop methods to assess older adults' digital health literacy levels.ObjectiveThis study aimed to develop a tool to measure digital health literacy. To this end, it reviewed existing literature to identify the components of digital health literacy, drafted preliminary items, and developed a scale using a representative sample.MethodsWe conducted a primary survey targeting 600 adults aged 55-75 years and performed an exploratory factor analysis on 74 preliminary items. Items with low factor loadings were removed, and their contents were modified to enhance their validity. Then, we conducted a secondary survey with 400 participants to perform exploratory and confirmatory factor analyses.ResultsA digital health literacy scale consisting of 25 items was developed, comprising 4 subfactors: use of digital devices, understanding health information, use and decision regarding health information, and use intention. The model fit indices indicated excellent structural validity (Tucker-Lewis Index=0.924, comparative fit index=0.916, root-mean-square error of approximation=0.088, standardized root-mean-square residual=0.044). High convergent validity (average variance extracted>0.5) and reliability (composite reliability>0.7) were observed within each factor. Discriminant validity was also confirmed as the square root of the average variance extracted was greater than the correlation coefficients between the factors. This scale demonstrates high reliability and excellent structural validity.ConclusionsThis study is a significant first step toward enhancing digital health literacy among older adults by developing an appropriate tool for measuring digital health literacy. We expect this study to contribute to the future provision of tailored education and treatment based on individual literacy levels.
| S-EPMC11840366 | biostudies-literature
Project description:To manoeuvre a complex and fragmented health care system, people need sufficient navigational health literacy (NAV-HL). The objective of this study was to validate the HLS19-NAV measurement scale applied in the European Health Literacy Population Survey 2019-2021 (HLS19). From December 2019 to January 2021, data on NAV-HL was collected in eight European countries. The HLS19-NAV was translated into seven languages and successfully applied in and validated for eight countries, where language and survey method differed. The psychometric properties of the scale were assessed using confirmatory factor analysis (CFA) and Rasch modelling. The tested CFA models sufficiently well described the observed correlation structures. In most countries, the NAV-HL data displayed acceptable fit to the unidimensional Rasch partial credit model (PCM). For some countries, some items showed poor data-model fit when tested against the PCM, and some items displayed differential item functioning for selected person factors. The HLS19-NAV demonstrated high internal consistency. To ensure content validity, the HLS19-NAV was developed based on a conceptual framework. As an estimate of discriminant validity, the Pearson correlations between the NAV-HL and general health literacy (GEN-HL) scales were computed. Concurrent predictive validity was estimated by testing whether the HLS19-NAV, like general HL measures, follows a social gradient and whether it forms a predictor of general health status as a health-related outcome of general HL. In some countries, adjustments at the item level may be beneficial.
| S-EPMC9654211 | biostudies-literature
Project description:The role of health literacy on HIV outcomes has not been evaluated widely in Africa, in part because few appropriate literacy measures exist. We developed a 16-item scale, the HIV Literacy Test (HIV-LT) to assess literacy-related tasks needed to participate in HIV care. Items were scored as correct or incorrect; higher scores indicated higher literacy skill (range 0-100 %). We tested internal reliability (Kuder-Richardson coefficient) of the HIV-LT in a convenience sample of 319 Portuguese-speaking, HIV infected adults on antiretroviral treatment in Maputo, Mozambique. Construct validity was assessed by a hypothetical model developed a priori. The HIV-LT was reliable and valid to measure participants' literacy skills. The mean HIV-LT score was 42 %; literacy skills applicable to HIV care were challenging for many participants. The HIV-LT could be used to assess the relationship of literacy and HIV-related outcomes in diverse settings, and evaluate interventions to improve health communication for those in HIV care.
| S-EPMC5306223 | biostudies-literature
Project description:BackgroundThere is no special instrument to measure skills-based health literacy where it concerns infectious respiratory diseases. This study aimed to explore and evaluate a new skills-based instrument on health literacy regarding respiratory infectious diseases.MethodsThis instrument was designed to measure not only an individual's reading and numeracy ability, but also their oral communication ability and their ability to use the internet to seek information. Sixteen stimuli materials were selected to enable measurement of the skills, which were sourced from the WHO, China CDC, and Chinese Center of Health Education. The information involved the distribution of epidemics, immunization programs, early symptoms, means of disease prevention, individual's preventative behavior, use of medications and thermometers, treatment plans and the location of hospitals. Multi-stage stratified cluster sampling was employed to collect participants. Psychometric properties were used to evaluate the reliability and validity of the instrument.ResultsThe overall degree of difficulty and discrimination of the instrument were 0.693 and 0.482 respectively. The instrument demonstrated good internal consistency reliability with a Cronbach's alpha of 0.864. As for validity, six factors were extracted from 30 items, which together explained 47.3% of the instrument's variance. And based on confirmatory factor analysis, the items were grouped into five subscales representing prose, document, quantitative, oral and internet based information seeking skills (χ(2) = 9.200, P>0.05, GFI = 0.998, TLI = 0.988, AGFI = 0.992, RMSEA = 0.028).ConclusionThe new instrument has good reliability and validity, and it could be used to assess the health literacy regarding respiratory infectious disease status of different groups.
| S-EPMC3665814 | biostudies-literature
Project description:ObjectiveThe present work aimed at cross-cultural adaptation and validation of the health literacy assessment tool Newest Vital Sign (NVS) in general population (GP) and highly educated (HE) samples of Brazilian adults.DesignAn expert committee reviewed the translation and back-translation processes and the cultural adaptation. The construct validity was analysed with confirmatory factor analysis and via associations with features of the study population.SettingThe final validation test was performed in two different populations from Londrina, a large town in southern Brazil.SubjectsBrazilian adults: GP (adult clients of community pharmacies; n 189) and HE (public school teachers; n 301).ResultsThe tool under validation showed good cross-cultural adaptation and internal consistency, with Cronbach's α of 0·75 for GP and 0·74 for HE. Confirmatory factor analysis showed acceptable models and identified two independent factors according to the relationship between components and numeracy for both GP and HE data. According to the Brazilian Portuguese version of the NVS instrument (NVS-BR), 48·7 % of GP and 33·5 % of HE presented adequate health literacy; this condition was inversely associated with age for both populations and directly correlated with educational level for GP.ConclusionsThe NVS-BR showed good validity in two different populations of Brazilian adults and can be considered an alternative in screening for inadequate health literacy.
| S-EPMC10261308 | biostudies-literature