The Brief Health Literacy Scale for Adults: Adaptation and Validation of the Health Literacy for School-Aged Children Questionnaire

TY - JOUR

T1 - The Brief Health Literacy Scale for Adults

T2 - Adaptation and Validation of the Health Literacy for School-Aged Children Questionnaire

AU - Rasmussen, Stinne Eika

AU - Aaby, Anna

AU - Søjbjerg, Anne

AU - Mygind, Anna

AU - Maindal, Helle Terkildsen

AU - Paakkari, Olli

AU - Christensen, Kaj Sparle

PY - 2023/11

Y1 - 2023/11

N2 - The Health Literacy for School-Aged Children (HLSAC) is a brief, generic instrument measuring health literacy among school-aged children. Given its brevity and broad conceptualization of health literacy, the HLSAC is a potentially valuable measuring instrument among adults as well. This validation study aimed to adapt the HLSAC questionnaire to an adult population through assessment of content validity and subsequently determine the structural validity of the adapted instrument, the Brief Health Literacy scale for Adults (B-HLA). The content validity of the HLSAC was assessed through interviews with respondents and experts, and the structural validity of the adapted instrument (B-HLA) was evaluated using Rasch analysis. The content validity assessment (n = 25) gave rise to adjustments in the wording of five items. The B-HLA demonstrated an overall misfit to the Rasch model (n = 290). Items 6 and 8 had the poorest individual fits. We found no signs of local dependency or differential item functioning concerning sex, age, education, and native language. The B-HLA demonstrated unidimensionality and ability to discriminate across health literacy levels (PSI = 0.80). Discarding items 6 or 8 resulted in an overall model fit and individual fit of all items. In conclusion, the B-HLA appears to be a valid and reliable instrument for assessing health literacy among adults.

AB - The Health Literacy for School-Aged Children (HLSAC) is a brief, generic instrument measuring health literacy among school-aged children. Given its brevity and broad conceptualization of health literacy, the HLSAC is a potentially valuable measuring instrument among adults as well. This validation study aimed to adapt the HLSAC questionnaire to an adult population through assessment of content validity and subsequently determine the structural validity of the adapted instrument, the Brief Health Literacy scale for Adults (B-HLA). The content validity of the HLSAC was assessed through interviews with respondents and experts, and the structural validity of the adapted instrument (B-HLA) was evaluated using Rasch analysis. The content validity assessment (n = 25) gave rise to adjustments in the wording of five items. The B-HLA demonstrated an overall misfit to the Rasch model (n = 290). Items 6 and 8 had the poorest individual fits. We found no signs of local dependency or differential item functioning concerning sex, age, education, and native language. The B-HLA demonstrated unidimensionality and ability to discriminate across health literacy levels (PSI = 0.80). Discarding items 6 or 8 resulted in an overall model fit and individual fit of all items. In conclusion, the B-HLA appears to be a valid and reliable instrument for assessing health literacy among adults.

KW - Humans

KW - Adult

KW - Child

KW - Health Literacy

KW - Psychometrics/methods

KW - Reproducibility of Results

KW - Surveys and Questionnaires

KW - Language

KW - Rasch analysis

KW - Health literacy for school-aged children

KW - Measuring instrument

KW - Psychometrics

KW - adults

KW - psychometrics

KW - health literacy

KW - health literacy for school-aged children

KW - measuring instrument

KW - surveys and questionnaires

UR - http://www.scopus.com/inward/record.url?scp=85177691974&partnerID=8YFLogxK

U2 - 10.3390/ijerph20227071

DO - 10.3390/ijerph20227071

M3 - Journal article

C2 - 37998302

SN - 1661-7827

VL - 20

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

IS - 22

M1 - 7071

ER -