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

Stinne Eika Rasmussen (), Anna Aaby, Anne Søjbjerg, Anna Mygind, Helle Terkildsen Maindal, Olli Paakkari and Kaj Sparle Christensen
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Stinne Eika Rasmussen: Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark
Anna Aaby: Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark
Anne Søjbjerg: Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark
Anna Mygind: Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark
Helle Terkildsen Maindal: Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark
Olli Paakkari: Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Keskussairaalantie 4, 40014 Jyväskylä, Finland
Kaj Sparle Christensen: Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark

IJERPH, 2023, vol. 20, issue 22, 1-13

Abstract: 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.

Keywords: health literacy; psychometrics; surveys and questionnaires; adults; health literacy for school-aged children; measuring instrument; Rasch analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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