Cross-cultural validation of health literacy measurement tools in Italian oncology patients

Abstract

BackgroundThe aim of this study was to assess the psychometric characteristics of four Health Literacy (HL) measurement tools, viz. Newest Vital Sign (NVS), Short Test of Functional Health Literacy in Adults (STOFHLA), Single Item Literacy Screener (SILS) and Single question on Self-rated Reading Ability (SrRA) among Italian oncology patients.MethodsThe original version of the tools were translated from the English language into Italian using a standard forward-backward procedure and according to internationally recognized good practices. Their internal consistency (reliability) and validity (construct, convergent and discriminative) were tested in a sample of 245 consecutive cancer patients recruited from seven Italian health care centers.ResultsThe internal consistency of the STOFHLA-I was Chronbach’s α=0.96 and that of NVS-I was α=0.74. The STOFHLA-I, NVS-I, SILS-I and SrRA-I scores were in a good relative correlation and in all tools the discriminative known-group validity was confirmed. The reliability and validity values were similar to those obtained from other cultural context studies.ConclusionThe psychometric characteristics of the Italian version of NVS, STHOFLA, SILS and SrRA were found to be good, with satisfactory reliability and validity. This indicates that they could be used as a screening tool in Italian patients. Moreover, the use of the same cross-cultural tools, validated in different languages, is essential for implementing multicenter studies to measure and compare the functional HL levels across countries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2359-0) contains supplementary material, which is available to authorized users.

Health Literacy: Current Status and Challenges in the Work of Family Doctors in Bosnia and Herzegovina

“…In our study, 34.6% of respondents demonstrated inadequate and marginal health literacy, a figure similar to other studies where the prevalence of inadequate health literacy varied between 32% and 59% [8,12,13,14,19,20]. Additionally, the healthcare of the respondents was not significantly influenced by gender [13,21]; however, other studies [12,22,23,24] that referenced gender found it was a relevant factor in determining health literacy. The overall health literacy score of study respondents decreased as their age increased, a similar pattern to many other studies [11,12,13,14,15,16,17,18,19,20,21,22,24,25,26,27,28,29,30], while research groups in Japan and Switzerland did not categorize age as a relevant factor in individual health literacy in their study populations [31,32].…”

“…In this study, health literacy among respondents living in urban communities was significantly higher in comparison to those who lived in rural communities, as was found by Parker [34]. Education level also had a significant impact on health literacy in several other studies [12,13,14,17,21,29,30,35], but not one in Japan [31].…”

“…Additionally, the healthcare of the respondents was not significantly influenced by gender [13,21]; however, other studies [12,22,23,24] that referenced gender found it was a relevant factor in determining health literacy. The overall health literacy score of study respondents decreased as their age increased, a similar pattern to many other studies [11,12,13,14,15,16,17,18,19,20,21,22,24,25,26,27,28,29,30], while research groups in Japan and Switzerland did not categorize age as a relevant factor in individual health literacy in their study populations [31,32]. We found that health literacy profoundly decreased in respondents that were not in a marriage relationship, a relationship similar to that found in a study in the United States [33], but not in an Italian study [19].…”

What is the Prevalence of Low Health Literacy in European Union Member States? A Systematic Review and Meta-analysis

“…The other tools were used in a limited number of studies, from one to three each (Table 1). Most studies investigated HL using selfreported comprehension items 26,27,30,33,34,36,38,44,[48][49][50]54,55,58,60,61,67,68,[70][71][72][74][75][76]78,81,83,85,86 Patients with chronic diseases were investigated in 25 studies 28,35,37,38,41,42,46,49,66,68,69,71,74,77,79,82,85 , whereas a smaller number of studies (n = 6) looked at oncology patients 47,61,75,…”

“…In Ireland 10,30,37,38,41,42,49 , the pooled estimates varied between 19% (95% CI: 17-22%, df = 4, Q = 7.6, I 2 = 46.8%), 40% (95% CI: 37-43%), 41% (95% CI: 21-65%; df = 3, Q = 194.9, I 2 = 98.4%), and 65% (95% CI: 46-81%). Italy low HL pooled estimates were by self-reported comprehension items 61,65,66 42% (95% CI: 33-51%; df = 2, Q = 12.4, I 2 = 84.5%); by reading or numeracy comprehension items 61,66,67 , 38% (95% CI: 35-41%; df = 2, Q = 1.5, I 2 = 0.0%); by word recognition items 64,65 , 72% (95% CI: 32-93%; df = 2, Q = 70.8, I 2 = 97.9%); and by mixed method 58 , 54% (95% CI: 51-57%). As for Portugal 54,55,57,59,70 , the low HL prevalence estimates varied between 21% (95% CI: 8-46%, df = 5, Q = 86.1, I 2 = 96.5%), 29% (95% CI: 6-73%, df = 4, Q = 139.1, I 2 = 98.2%), and 50% (95% CI: 48-52%).…”