Psychometric Properties of the Adapted Instrument European Health Literacy Survey Questionnaire Short-short Form

Overview

Journal Rev Lat Am Enfermagem

Specialty Nursing

Date 2021 Jul 7

PMID 34231791

Citations 9

Authors

Fabio Luiz Mialhe

Katarinne Lima Moraes

Fernanda Maria Rovai Bado

Virginia Visconde Brasil

Helena Alves de Carvalho Sampaio

Flavio Rebustini

Affiliations

Soon will be listed here.

Abstract

Objective: to investigate the psychometric properties of the Brazilian Portuguese version of the health literacy questionnaire European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults.

Method: the instrument was translated and pre-tested in a sample of 50 individuals. Subsequently, it was applied to a sample of 783 adult individuals. The data went through an appropriate process of testing the properties, with the combination of techniques of Exploratory Factor Analysis, Confirmatory Factor Analysis and Item Response Theory. For the assessment of reliability, the Cronbach's alpha and McDonald's Omega indicators were used. Cross-validation with full data analysis was applied.

Results: the majority of the participants was female (68.1%), with a mean age of 38.6 (sd=14.5) years old and 33.5% studied up to elementary school. The results indicated a unidimensional model with an explained variance of 71.23%, adequate factor load levels, commonality and item discrimination, as well as stability and replicability of the instrument to other populations.

Conclusion: the Brazilian version of HLS-EU-Q6 indicated that the instrument is suitable for indiscriminate application in the population to which it is intended to assess health literacy levels.

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References

Liu C, Wang D, Liu C, Jiang J, Wang X, Chen H . What is the meaning of health literacy? A systematic review and qualitative synthesis. Fam Med Community Health. 2020; 8(2). PMC: 7239702. DOI: 10.1136/fmch-2020-000351. View

Rodriguez A, Reise S, Haviland M . Applying Bifactor Statistical Indices in the Evaluation of Psychological Measures. J Pers Assess. 2015; 98(3):223-37. DOI: 10.1080/00223891.2015.1089249. View

Gutlein M, Helma C, Karwath A, Kramer S . A Large-Scale Empirical Evaluation of Cross-Validation and External Test Set Validation in (Q)SAR. Mol Inform. 2016; 32(5-6):516-28. DOI: 10.1002/minf.201200134. View

Schinckus L, Dangoisse F, Van den Broucke S, Mikolajczak M . When knowing is not enough: Emotional distress and depression reduce the positive effects of health literacy on diabetes self-management. Patient Educ Couns. 2017; 101(2):324-330. DOI: 10.1016/j.pec.2017.08.006. View

Liu H, Zeng H, Shen Y, Zhang F, Sharma M, Lai W . Assessment Tools for Health Literacy among the General Population: A Systematic Review. Int J Environ Res Public Health. 2018; 15(8). PMC: 6122038. DOI: 10.3390/ijerph15081711. View

Maragno C, Mengue S, Garcia Moraes C, Rebelo M, Guimaraes A, Dal Pizzol T . Test of health Literacy for Portuguese-speaking Adults. Rev Bras Epidemiol. 2019; 22:e190025. DOI: 10.1590/1980-549720190025. View

Nguyen T, Paasche-Orlow M, McCormack L . The State of the Science of Health Literacy Measurement. Stud Health Technol Inform. 2017; 240:17-33. PMC: 6082165. View

Reichenheim M, Moraes C . [Operationalizing the cross-cultural adaptation of epidemiological measurement instruments]. Rev Saude Publica. 2007; 41(4):665-73. DOI: 10.1590/s0034-89102006005000035. View

Palumbo R . Examining the impacts of health literacy on healthcare costs. An evidence synthesis. Health Serv Manage Res. 2017; 30(4):197-212. DOI: 10.1177/0951484817733366. View

10.

Auerswald M, Moshagen M . How to determine the number of factors to retain in exploratory factor analysis: A comparison of extraction methods under realistic conditions. Psychol Methods. 2019; 24(4):468-491. DOI: 10.1037/met0000200. View

11.

Jordan P, Spiess M . Rethinking the Interpretation of Item Discrimination and Factor Loadings. Educ Psychol Meas. 2019; 79(6):1103-1132. PMC: 6777065. DOI: 10.1177/0013164419843164. View

12.

Ferrando P, Lorenzo-Seva U . Assessing the Quality and Appropriateness of Factor Solutions and Factor Score Estimates in Exploratory Item Factor Analysis. Educ Psychol Meas. 2020; 78(5):762-780. PMC: 7328234. DOI: 10.1177/0013164417719308. View

13.

Duong T, Aringazina A, Baisunova G, Nurjanah , Pham T, Pham K . Measuring health literacy in Asia: Validation of the HLS-EU-Q47 survey tool in six Asian countries. J Epidemiol. 2017; 27(2):80-86. PMC: 5328731. DOI: 10.1016/j.je.2016.09.005. View

14.

Beaton D, Bombardier C, Guillemin F, Ferraz M . Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000; 25(24):3186-91. DOI: 10.1097/00007632-200012150-00014. View

15.

Timmerman M, Lorenzo-Seva U . Dimensionality assessment of ordered polytomous items with parallel analysis. Psychol Methods. 2011; 16(2):209-20. DOI: 10.1037/a0023353. View

16.

Finch W . Using Fit Statistic Differences to Determine the Optimal Number of Factors to Retain in an Exploratory Factor Analysis. Educ Psychol Meas. 2020; 80(2):217-241. PMC: 7047263. DOI: 10.1177/0013164419865769. View

17.

Rouquette A, Nadot T, Labitrie P, Van den Broucke S, Mancini J, Rigal L . Validity and measurement invariance across sex, age, and education level of the French short versions of the European Health Literacy Survey Questionnaire. PLoS One. 2018; 13(12):e0208091. PMC: 6283623. DOI: 10.1371/journal.pone.0208091. View

18.

McNeish D . Thanks coefficient alpha, we'll take it from here. Psychol Methods. 2017; 23(3):412-433. DOI: 10.1037/met0000144. View

19.

Lorini C, Lastrucci V, Mantwill S, Vettori V, Bonaccorsi G . Measuring health literacy in Italy: a validation study of the HLS-EU-Q16 and of the HLS-EU-Q6 in Italian language, conducted in Florence and its surroundings. Ann Ist Super Sanita. 2019; 55(1):10-18. DOI: 10.4415/ANN_19_01_04. View

20.

Nutbeam D, McGill B, Premkumar P . Improving health literacy in community populations: a review of progress. Health Promot Int. 2017; 33(5):901-911. DOI: 10.1093/heapro/dax015. View