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HLS 19 -NAV—Validation of a New Instrument Measuring Navigational Health Literacy in Eight European Countries

Author

Listed:
  • Lennert Griese

    (School of Public Health, Bielefeld University, 33615 Bielefeld, Germany)

  • Hanne S. Finbråten

    (Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, 2418 Elverum, Norway)

  • Rita Francisco

    (Católica Research Centre for Psychological, Family and Social Well-Being, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal)

  • Saskia M. De Gani

    (Careum Foundation, Careum Center for Health Literacy, 8032 Zurich, Switzerland
    Careum School of Health, Kalaidos University of Applied Sciences, 8006 Zurich, Switzerland)

  • Robert Griebler

    (Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria)

  • Øystein Guttersrud

    (Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway)

  • Rebecca Jaks

    (Careum Foundation, Careum Center for Health Literacy, 8032 Zurich, Switzerland)

  • Christopher Le

    (Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, 2418 Elverum, Norway
    Department of Social Determinants of Health, Division of Prevention and Public Health, Norwegian Directorate of Health, 0213 Oslo, Norway)

  • Thomas Link

    (Department of Quality Measurement and Patient Survey, Austrian National Public Health Institute, A-1010 Vienna, Austria)

  • Andreia Silva da Costa

    (Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1049-005 Lisboa, Portugal
    Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisboa, Portugal)

  • Miguel Telo de Arriaga

    (Católica Research Centre for Psychological, Family and Social Well-Being, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
    Direção-Geral da Saúde, 1049-005 Lisboa, Portugal)

  • Rajae Touzani

    (Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Equipe CANBIOS Labellisée Ligue 2019, 13009 Marseille, France
    Institut Paoli-Calmettes, SESSTIM U1252, 13009 Marseille, France)

  • Mitja Vrdelja

    (Communication Unit, National Institute of Public Health, 1000 Ljubljana, Slovenia)

  • Jürgen M. Pelikan

    (WHO-CC Health Promotion in Hospitals and Health Care, Austrian National Public Health Institute, A-1010 Vienna, Austria)

  • Doris Schaeffer

    (School of Public Health, Bielefeld University, 33615 Bielefeld, Germany)

Abstract

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 HLS 19 -NAV measurement scale applied in the European Health Literacy Population Survey 2019–2021 (HLS 19 ). From December 2019 to January 2021, data on NAV-HL was collected in eight European countries. The HLS 19 -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 HLS 19 -NAV demonstrated high internal consistency. To ensure content validity, the HLS 19 -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 HLS 19 -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.

Suggested Citation

  • Lennert Griese & Hanne S. Finbråten & Rita Francisco & Saskia M. De Gani & Robert Griebler & Øystein Guttersrud & Rebecca Jaks & Christopher Le & Thomas Link & Andreia Silva da Costa & Miguel Telo de , 2022. "HLS 19 -NAV—Validation of a New Instrument Measuring Navigational Health Literacy in Eight European Countries," IJERPH, MDPI, vol. 19(21), pages 1-20, October.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:13863-:d:952777
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    References listed on IDEAS

    as
    1. Susanne Schnitzer & Raphael Kohl & Hella Fügemann & Kathrin Gödde & Judith Stumm & Fabian Engelmann & Ulrike Grittner & Nina Rieckmann, 2022. "Patient Navigation—Who Needs What? Awareness of Patient Navigators and Ranking of Their Tasks in the General Population in Germany," IJERPH, MDPI, vol. 19(5), pages 1-13, March.
    2. Rosseel, Yves, 2012. "lavaan: An R Package for Structural Equation Modeling," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 48(i02).
    3. Maria M. Hofmarcher & Howard Oxley & Elena Rusticelli, 2007. "Improved Health System Performance through better Care Coordination," OECD Health Working Papers 30, OECD Publishing.
    4. Lennert Griese & Eva-Maria Berens & Peter Nowak & Jürgen M. Pelikan & Doris Schaeffer, 2020. "Challenges in Navigating the Health Care System: Development of an Instrument Measuring Navigation Health Literacy," IJERPH, MDPI, vol. 17(16), pages 1-17, August.
    5. Hanne Søberg Finbråten & Peter Nowak & Robert Griebler & Éva Bíró & Mitja Vrdelja & Rana Charafeddine & Lennert Griese & Henrik Bøggild & Doris Schaeffer & Thomas Link & Zdenek Kucera & Julien Mancini, 2022. "The HLS 19 -COM-P, a New Instrument for Measuring Communicative Health Literacy in Interaction with Physicians: Development and Validation in Nine European Countries," IJERPH, MDPI, vol. 19(18), pages 1-23, September.
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