Dataset Information

Conceptualization, Development and Psychometric Evaluations of a New Medication-Related Health Literacy Instrument: The Chinese Medication Literacy Measurement.

ABSTRACT: There is a need for valid and reliable instruments to focus on medication aspects of health literacy and help healthcare professionals address patients' barriers to medication use. This cross-sectional study describes the conceptualization, development, and psychometric properties of the first Chinese Medication Literacy Measurement (ChMLM) to assess the level of health literacy on medication use. The 17-item ChMLM (ChMLM-17) and its short form, 13-item ChMLM (ChMLM-13), consist of four sections (vocabulary, over-the-counter labels, prescription labels, and advertisements) to cover six domains of medication-related health literacy. Multistage stratified quota sampling was attempted to recruit a representative sample in Taiwan. Receiver operating characteristic curves were used to identify the cut-off point for differentiating high and low medication literacy. Psychometric analyses were performed (n = 1410) to assess the reliability and validity separately on all samples and sociodemographic subgroups. The 17- and 13-item versions both had high construct validity among all patients and patients with low medication literacy. The developed ChMLM-17 and ChMLM-13 is expected to help healthcare providers and researchers to accurately measure medication-related health literacy and improve medication use in the real-world practice.

SUBMITTER: Lin HW

PROVIDER: S-EPMC7579017 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Conceptualization, Development and Psychometric Evaluations of a New Medication-Related Health Literacy Instrument: The Chinese Medication Literacy Measurement.

Lin Hsiang-Wen HW Chang Elizabeth H EH Ko Yu Y Wang Chun-Yu CY Wang Yu-Shan YS Mafruhah Okti Ratna OR Wu Shang-Hua SH Chen Yu-Chieh YC Huang Yen-Ming YM

International journal of environmental research and public health 20200923 19

There is a need for valid and reliable instruments to focus on medication aspects of health literacy and help healthcare professionals address patients' barriers to medication use. This cross-sectional study describes the conceptualization, development, and psychometric properties of the first Chinese Medication Literacy Measurement (ChMLM) to assess the level of health literacy on medication use. The 17-item ChMLM (ChMLM-17) and its short form, 13-item ChMLM (ChMLM-13), consist of four sections ...[more]

PMID: 32977520

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Project description:Objective:To develop the medication literacy scale for patients with hypertension, and to test the reliability and validity of the scale. Methods:The initial draft of the scale was formulated based on the operationalization of medication literacy with four core elements of knowledge, attitude, skill, and practice, and was developed through procedures of literature review, interviews to hypertensive patients, and research group discussion. Expert panel meeting, interviews, and pre-test on the initial draft of the scale to 10 hypertensive patients, as well as a two iterations of expert feedback were used to form a primary medication literacy scale for pilot investigation and item selection. In this study, 260 patients with hypertension in Changsha city of China were purposively selected to conduct a pilot survey using the primary medication literacy scale. After item selection by a series of statistical analysis method and item re-wording according to patients' feedback, the scale was revised to form a formal investigation scale with four domains and 37 items. A formal investigation was carried out on 650 patients with hypertension selected purposively in a tertiary general hospital and two community health service centers in Changsha city of China. The reliability and validity of the scale were analyzed. Results:Finally, the formal scale consists of four domains on knowledge, attitude, practice and skills, 11 sub-factors and 37 items in total. The scale-level content validity index (S-CVI/Ave) of this scale was 0.968, and the I-CVI for each item ranged from 0.833 to 1.000, indicating a good and acceptable content and face validity. The Cronbach's ? coefficient was 0.849 for the overall scale and ranged from 0.744 to 0.783 for domains. The Pearson's correlation coefficients between domains and the total scale were ranging from 0.530 to 0.799. Besides, the Pearson's correlation coefficient among domains of the scale ranged from 0.157 to 0.439. The Spearman-Brown split-half reliability coefficient was 0.893 for the total scale and ranged from 0.793 to 0.872 for domains. The test-retest reliability coefficient of the total scale was 0.968 and ranged from 0.880 to 0.959 for domains. Four domains of knowledge, attitude, skill, and practice were identified through the exploratory factor analysis and confirmatory factor analysis from each domain. The total explained variation of domains for the overall scale was 51.420%. Eleven sub-factors for domains were extracted through respective exploratory factor analysis from each domain, and the total explained variation of sub-factors for its belonging domain were ranging from 56.111 to 64.419%. The confirmatory factor analysis showed the fit indices of the four-domain model were as follows (?2/df=2.629, GFI=0.804, AGFI=0.777, RMR=0.012, IFI=0.746, RMSEA=0.066, PNFI=0.599, PCFI=0.689), which indicated an acceptable model fit. Conclusions:The medication literacy scale for hypertensive patients has good reliability and acceptable validity, which is suitable and acceptable for evaluating the medication literacy level of hypertension patients in China. In the future, further construct and model fit validation and English translation with appropriate adaptation of this whole scale are required, so that this scale can be further validated and applied worldwide.

Project description:BACKGROUND:Oral health literacy is an important construct for both clinical and public health outcomes research. The need to quantify and test OHL has led to the development of measurement instruments and has generated a substantial body of recent literature. A commonly used OHL instrument is REALD-30, a word recognition scale that has been adapted for use in several languages. The objective of this study was the development and testing of the Greek language oral health literacy measurement instrument (GROHL). METHODS:Data from 282 adult patients of two private dental clinics in Athens, Greece were collected via in-person interviews. Forty-four words were initially considered and tested for inclusion. Item response theory analysis (IRT) and 2-parameter logistic models assessing difficulty and discriminatory ability were used to identify an optimal scale composition. Internal consistency was examined using Cronbach's alpha and test-retest reliability was measured using intraclass correlation coefficient (ICC) in a subset of 20 participants over a two-week period. Convergent validity was tested against functional health literacy screening (HLS) items, dental knowledge (DK), oral health behaviors (OHBs), oral health-related quality of life (OHRQoL; OHIP-14 index), as well as self-reported oral and general health status. RESULTS:From an initial item pool of 44 items that were carried forward to IRT, 12 were excluded due to no or little variance, 10 were excluded due to low item-test correlation, and 2 due to insignificant contribution to the scale, i.e., difficulty parameter estimate with p?>?0.05. The twenty remaining items composed the final index which showed favorable internal consistency (alpha?=?0.80) and test-retest reliability (ICC?=?0.95). The summary score distribution did not depart from normality (p?=?0.32; mean?=?11.5; median?=?12; range?=?1-20). GROHL scores were positively correlated with favorable oral hygiene behaviors and dental attendance, as well as HLS, DK and education level. CONCLUSION:The GROHL demonstrated good psychometric properties and can be used for outcomes research in clinical and public health settings.

Project description:Wellbeing literacy is the intentional use of wellbeing relevant vocabulary, knowledge and language skills to maintain or improve the wellbeing of oneself, others and the world. In this study, we operationalize the human aspects of the concept of wellbeing literacy and empirically test its relationship with wellbeing and illbeing. We also assess its incremental variance in wellbeing and illbeing, after controlling for existing and well-established predictors of these constructs within education settings. We developed and empirically tested the Wellbeing literacy 6-item (Well-Lit 6) scale to assess the concept of wellbeing literacy in the education context. The scale was developed based on a working definition of wellbeing literacy, in combination with the Australian Curriculum, Assessment and Reporting Authority (ACARA)'s definition of literacy. The Well-Lit 6 was administered via a cross-sectional survey to three Australian samples that comprise different elements of Australian education systems: students (N = 1392), parents (N = 584) and school staff (N = 317). Exploratory factor analysis (EFA) suggested the six items of the Well-Lit 6 form an independent construct, empirically distinguishable from other wellbeing-related constructs (e.g., general wellbeing, resilience, and emotion regulation). Convergent analyses showed wellbeing literacy was positively related to wellbeing and negatively related to illbeing. Incremental validity analyses showed wellbeing literacy predicted variance in wellbeing and illbeing after controlling for participant demographics, resilience, and emotion regulation, showing initial evidence of incremental validity. Our results provide preliminary evidence that wellbeing literacy is a distinct construct from wellbeing and illbeing, and it also demonstrates significant unique variance in these constructs over and above resilience and emotion regulation. The Well-Lit 6 is a useful provisional measure of wellbeing literacy, although we suggest a fruitful avenue for future research is to develop a more comprehensive scale of wellbeing literacy that denotes specific facets of communication, allowing a fuller exploration wellbeing literacy, its components, and their antecedents and consequences. We offer further recommendations for future research and discuss limitations with our approach.

Project description:BackgroundA high quality treatment decision means patients are informed and receive treatment that matches their goals. This research examined the reliability and validity of the Depression Decision Quality Instrument (DQI), a survey to measure the extent to which patients are informed and received preferred treatment for depression.MethodsParticipants were aged 18 and older from 17 US cities who discussed medication or counseling with a physician in the past year, and physicians who treated patients with depression who practiced in the same cities. Participants were mailed a survey that included the Depression-DQI, a tool with 10 knowledge and 7 goal and concern items. Patients were randomly assigned to either receive a patient decision aid (DA) on treatment of depression or no DA. A matching score was created by comparing the patient's preferred treatment to their self-reported treatment received. Concordant scores were considered matched, discordant were not. We examined the reliability and known group validity of the Depression-DQI.ResultsMost patients 405/504 (80%) responded, 79% (320/405) returned the retest survey, and 60% (114/187) of physicians returned the survey. Patients' knowledge scores on the 10-item scale ranged from 14.6 to 100% with no evidence of floor or ceiling effects. Retest reliability for knowledge was moderate and for goals and concerns ranged from moderate to good. Mean knowledge scores differentiated between patients and physicians (M = 63 [SD = 15] vs. M = 81 [SD = 11], p < 0.001), and between patients who did and didn't receive a DA (M = 64 [SD = 16] vs. M = 61 [SD = 14], p = 0.041). 60.5% of participants received treatment that matched their preference. Based on the multivariate logistic regression, 'avoiding taking anti-depressants' was the only goal that was predictive of taking mediation (OR = 0.73 [0.66, 0.80], p < 0.01). Shared Decision Making Process scores were similar for those who matched their preference and those who didn't (M = 2.18 [SD = 0.97] vs. M = 2.06 [SD = 1.07]; t(320) = - 1.06, p = 0.29). Those who matched had lower regret scores (matched M = 1.72 [SD = 0.74] vs. unmatched M = 2.32 [SD = 0.8]; t(301) = - 6.6, p < .001).ConclusionsThe Depression DQI demonstrated modest reliability and validity. More work is needed to establish validity of the method to determine concordance.Trial registrationNCT01152307.

Dataset Information

Conceptualization, Development and Psychometric Evaluations of a New Medication-Related Health Literacy Instrument: The Chinese Medication Literacy Measurement.

Publications

Conceptualization, Development and Psychometric Evaluations of a New Medication-Related Health Literacy Instrument: The Chinese Medication Literacy Measurement.

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