Construct Validation of the Health Literacy Questionnaire (HLQ) in Shahrekord Cohort Study, Iran

Abstract

In addition, health literacy refers to the degree of the ability to obtain, communicate, accept, and understand health information and services, which enables individuals to make health-related decisions [4]. Health literacy is a predictor of health outcomes and healthcare utilization [5]. Low health literacy is associated with the less frequent use of preventative measures, inability to communicate with healthcare professionals, low adherence to recommended Journal of Human, Environment, and Health Promotion Journal homepage: www.zums.ac.ir/jhehp Background: Health literacy promotion is considered to be an important goal in the healthcare strategic planning of every country. The present study aimed to evaluate the validity and reliability of the health literacy questionnaire (HLQ) in the participants of Shahrekord cohort study, Iran. Methods: This cross-sectional study was conducted on 400 respondents who were selected via systematic, random sampling from the participants of Shahrekord cohort study. The content and construct validity of HLQ were determined, and the internal consistency of the questionnaire was evaluated using the Cronbach's alpha coefficient. Data analysis was performed in SPSS version 21. Results: The internal consistency and test-retest reliability (ICC) of the factors were higher than 0.7. The construct validity of HLQ was investigated using exploratory factor analysis, Kaiser-Meyer-Olkin test (0.89), and Bartlett's test (6908.425) (P ≤ 0.001) with VARIMAX rotation. Conclusion: According to the results, HLQ is a reliable and valid scale for the investigation of health literacy in Chaharmahal and Bakhtiari province, Iran. Since health literacy instruments should be revised regularly, further studies are recommended in order to evaluate health literacy using the HLQ to identify its possible deficiencies.

Measurement Properties of the Health Literacy Questionnaire in the Understanding Multiple Sclerosis Massive Open Online Course Cohort: A Rasch Analysis

“…The result of this study is consistent with previous work that found the HLQ to have good measurement properties with robust construct validity and reliability for each of its nine Domains ( Ahmadi & Salehi, 2019 ; Huang et al, 2019 ; Kolarcik et al, 2017 ; Maindal et al, 2016 ; Morris et al, 2017 ; Nolte et al, 2017 ; Osborne et al, 2013 ; Richtering et al, 2017 ). This indicates that the nine HLQ domains each consistently measure a single HL construct and together they provide reliable and valid information on nine distinct HL constructs.…”

“…We have shown that the HLQ can be used to measure HL in online health educational platforms. This adds to the existing knowledge on the validated modes of delivery for HL measurements such as self-administered paper-based, online/web-based, face-to-face, and telephone-based interviews that have been explored in different settings and populations ( Ahmadi & Salehi, 2019 ; Debussche et al, 2018 ; Huang et al, 2019 ; Jessup et al, 2017 ; Kolarcik et al, 2017 ; Maindal et al, 2016 ; Morris et al, 2017 ; Mullan et al, 2017 ; Nolte et al, 2017 ; Rademakers et al, 2020 ; Richtering et al, 2017 ).…”

“…The HLQ has excellent psychometric properties and has been culturally adapted and/or validated in different populations, settings, and languages. For example, it has been adapted and/or validated in German, ( Nolte et al, 2017 ), Danish ( Maindal et al, 2016 ), Slovakian ( Kolarcik et al, 2017 ), Dutch ( Rademakers et al, 2020 ), and Iranian cohorts ( Ahmadi & Salehi, 2019 ), as well as health professional university students ( Mullan et al, 2017 ), older adults ( Huang et al, 2019 ; Morris et al, 2017 ), people with metabolic and cardiovascular risk ( Debussche et al, 2018 ; Richtering et al, 2017 ), and recently hospitalized patients ( Jessup et al, 2017 ). However, despite the wide applicability of the HLQ, the suitability of an instrument may differ across settings or populations.…”

Non-communicable diseases in the southwest of Iran: profile and baseline data from the Shahrekord PERSIAN Cohort Study

“…The tools were used for baseline data collection from 2015 to 2019 and are described in Table 1 . In addition to the extensive standard PERSIAN questionnaires, additional questionnaires unique to SCS were also completed, including General Health [ 22 ], WHO Quality of Life-BREF [ 23 ], Chronic Stressors and Coping Strategies [ 24 ], WHO MONICA and the ROSE Angina questionnaire [ 25 ], Social Capital [ 26 ], Screening Tool for Joint Pain and Musculoskeletal Diseases [ 27 ], Health Literacy [ 28 ], Oxford Happiness [ 29 ], and Oswestry Low Back Pain Disability [ 30 ], following SCS protocols [ 18 ] in CH&B (Table 1 ) and additional data unique to SCS were also completed including body composition variables included total body water, body fat mass and percentage, and muscle thickness, which were measured using a body composition analyzer (Tanita, Japan). A spirometry test (pulmonary function test) was performed using the Spirometer device (Spirolab [MIR, Italy)].…”