Affiliation:
1. Fuwai Central China Cardiovascular Hospital
2. Community Health Centre of Chaohe
3. Technical University of Munich
4. Henan University of Science and Technology
5. Murdoch Children’s Research Institute
6. Zhengzhou University
Abstract
Abstract
Background
Health literacy measurement lays a solid foundation to identify associations with health outcomes and monitor population health literacy levels over time. In mainland China, most existing health literacy instruments are either knowledge-based or practice-based, making health literacy results incomparable between China and other countries. This study aimed to examine the reliability and validity of the 12-item Health Literacy Population Survey (HLS19-Q12) in a general population of Chinese adults.
Methods
A cross-sectional study was conducted to recruit primary carers of students from 11 schools in Zhengzhou, Henan Province, using convenience cluster sampling. Participants completed an online self-administered survey that collected information on key sociodemographics, health literacy (HLS19-Q12 and a comparison tool: Health Literacy Questionnaire (HLQ)), and health-related outcomes. Using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist as a guideline, we tested internal consistency, test-retest reliability, content validity, structural validity, concurrent predictive validity, and convergent validity of the HLS19-Q12.
Results
Overall, 14184 participants completed the full survey, resulting in a response rate of 87.6% (14184/16187). The HLS19-Q12 showed excellent internal consistency (Cronbach’s α = 0.93), moderate test-retest reliability (intra-class correlation coefficient = 0.54), satisfactory content validity (based on the 12-matrix health literacy model), and strong structural validity (comparative fit index = 0.94, Tucker and Lewis’s index of fit = 0.93, root mean square error of approximation = 0.095). Concurrent predictive validity results showed health literacy was associated with both health determinants and health-related outcomes. The HLS19-Q12 had moderate to strong correlations (coefficients = 0.24 to 0.42) with the nine scales of the HLQ. Respondents had an average score of 81.6 (± 23.0) when using the HLS19-Q12, with 35.0% and 7.5% having problematic and inadequate levels of health literacy, respectively.
Conclusions
The HLS19-Q12 is a reliable and valid instrument to measure health literacy in general populations of adults in China. The HLS19-Q12 can be used as a comprehensive, skills-based, and easy-to-administer health literacy assessment tool integrated into population surveys and intervention evaluations. The percentage of Chinese adults who had problematic or inadequate levels of health literacy was comparable with that of European adults. Improving health literacy has the potential to improve population health and reduce health inequities.
Publisher
Research Square Platform LLC
Reference41 articles.
1. The significance of health literacy for public health and health promotion;Bitzer EM;New Approaches to Health Literacy: Linking Different Perspectives
2. Health literacy and public health: a systematic review and integration of definitions and models;Sørensen K;BMC Public Health,2012
3. Measuring functional, interactive and critical health literacy of Chinese secondary school students: reliable, valid and feasible?;Guo S;Glob Health Promot,2018
4. Understanding and Responding to Health Literacy as a Social Determinant of Health;Nutbeam D;Annu Rev Public Health,2021
5. Yusoff HAM, Hamzah MR, Manaf ARA, Ismail A, Ahmad Y, Hussin H. The influence of health literacy on health outcomes: A systematic literature review perspective. In: 2021: AIP Publishing.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献