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Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS 19 -Q12 Instrument in Seventeen Countries

Author

Listed:
  • Jürgen M. Pelikan

    (Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
    HLS 19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria)

  • Thomas Link

    (Department of Quality Measurement and Patient Survey, Austrian National Public Health Institute, and HLS 19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria)

  • Christa Straßmayr

    (Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
    HLS 19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria)

  • Karin Waldherr

    (Ferdinand Porsche FernFH, A-2700 Wiener Neustadt, Austria)

  • Tobias Alfers

    (Department of Education and Psychology, Freie Universität Berlin, 14195 Berlin, Germany)

  • Henrik Bøggild

    (Public Health and Epidemiology, Health Science and Technology, Aalborg University, DK-9220 Aalborg, Denmark
    Unit of Clinical Biostatistics, Aalborg University Hospital, DK-9000 Aalborg, Denmark)

  • Robert Griebler

    (Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
    HLS 19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria)

  • Maria Lopatina

    (National Medical Research Center for Therapy and Preventive Medicine, Ministry of Health of the Russian Federation, 101000 Moscow, Russia)

  • Dominika Mikšová

    (Department of Quality Measurement and Patient Survey, Austrian National Public Health Institute, and HLS 19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria)

  • Marie Germund Nielsen

    (Public Health and Epidemiology, Health Science and Technology, Aalborg University, DK-9220 Aalborg, Denmark
    Clinical Nursing Research Unit, Aalborg University Hospital, DK-9000 Aalborg, Denmark)

  • Sandra Peer

    (Institute for Water Quality and Resource Management, TU Wien, A-1040 Vienna, Austria)

  • Mitja Vrdelja

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

Abstract

Background: For improving health literacy (HL) by national and international public health policy, measuring population HL by a comprehensive instrument is needed. A short instrument, the HLS 19 -Q12 based on the HLS-EU-Q47, was developed, translated, applied, and validated in 17 countries in the WHO European Region. Methods: For factorial validity/dimensionality, Cronbach alphas, confirmatory factor analysis (CFA), Rasch model (RM), and Partial Credit Model (PCM) were used. For discriminant validity, correlation analysis, and for concurrent predictive validity, linear regression analysis were carried out. Results: The Cronbach alpha coefficients are above 0.7. The fit indices for the single-factor CFAs indicate a good model fit. Some items show differential item functioning in certain country data sets. The regression analyses demonstrate an association of the HLS 19 -Q12 score with social determinants and selected consequences of HL. The HLS 19 -Q12 score correlates sufficiently highly (r ≥ 0.897) with the equivalent score for the HLS 19 -Q47 long form. Conclusions: The HLS 19 -Q12, based on a comprehensive understanding of HL, shows acceptable psychometric and validity characteristics for different languages, country contexts, and methods of data collection, and is suitable for measuring HL in general, national, adult populations. There are also indications for further improvement of the instrument.

Suggested Citation

  • Jürgen M. Pelikan & Thomas Link & Christa Straßmayr & Karin Waldherr & Tobias Alfers & Henrik Bøggild & Robert Griebler & Maria Lopatina & Dominika Mikšová & Marie Germund Nielsen & Sandra Peer & Mitj, 2022. "Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS 19 -Q12 Instrument in Seventeen Countries," IJERPH, MDPI, vol. 19(21), pages 1-31, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:14129-:d:957358
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    References listed on IDEAS

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    1. Andreia Costa & Rodrigo Feteira-Santos & Violeta Alarcão & Adriana Henriques & Teresa Madeira & Ana Virgolino & Miguel Arriaga & Paulo J. Nogueira, 2023. "Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related Factors," IJERPH, MDPI, vol. 20(5), pages 1-16, February.

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