Development and validation of assessments of adolescent health literacy: a Rasch measurement model approach

Fleary, Sasha A.; Freund, Karen M.; Nigg, Claudio R.

doi:10.1186/s12889-022-12924-4

Cited by 12 publications

(7 citation statements)

References 55 publications

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“…This study assessed the psychometric properties of the Assessments of Adult Health Literacy (AAHL-Adult), an adult version of the AAHL-Adolescent ( 21 ). This study was approved by the Tufts University Social Behavioral and Educational Institutional Review Board.…”

Section: Methodsmentioning

confidence: 99%

“…The AAHL-Adult is the adult version of the AAHL-Adolescent and includes three test-based HL assessments that align with Nutbeam’s ( 12 ) definitions of functional, interactive/communicative, and critical HL. The AAHL-Adolescent was developed using a multi-phase mixed methods design, and the questionnaire development process is summarized here and reported in detail elsewhere ( 21 ). The initial item bank for the AAHL-Adolescent was developed via an iterative process involving focus groups and cognitive interviews with adolescents and consultations with experts to ensure content and face validity.…”

Section: Methodsmentioning

confidence: 99%

“…Similar to the AAHL-Adolescent ( 21 ), participants were asked to endorse two behaviors including questions the truthfulness of health information found online and reads instructions before taking medicine, consistent with Sorenson and colleagues’ ( 2 ) description of the applied use aspect of HL. These items were used to establish criterion validity for the AAHL-Adult.…”

Section: Methodsmentioning

confidence: 99%

“…Given the lack of test-based assessments for interactive and critical HL, this study aimed to assess the validity of the Assessments of Adolescent Health Literacy (AAHL-Adolescent) in an adult sample. The AAHL-Adolescent includes test-based assessments of functional, interactive, and critical HL developed and validated in an adolescent sample using Rasch Measurement Models ( 21 ). The Rasch measurement model is a probabilistic model that applies sample-independent methodology by fitting data to a measurement model rather than to a sample, which is done in classical test theory ( 22 ).…”

Section: Current Studymentioning

confidence: 99%

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Validation of the Assessments of Adult Health Literacy: A Rasch Measurement Model Approach

Fleary

2023

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Background: Both the World Health Organization and U.S. Department for Health and Human Services have emphasized the importance of health literacy (HL) to improving population health and reducing health disparities. HL includes three core areas/qualities: functional (i.e., health-related reading, writing, and numeracy), interactive/communicative (i.e., skills for interacting with multiple constituents and sources of information and navigating the health environment), and critical (i.e., personal and community advocacy for health). HL is implicated in medical adherence, preventive health, mental health stigma and help-seeking, and health decision-making. Though HL is critical to health and health decision-making, research on HL is still relatively limited, with most research focusing on functional HL. A major gap in research is related to the lack of measurement of interactive and critical HL. To address this gap, this study modified and assessed the validity of the Assessments of Adolescent Health Literacy (AAHL-Adolescent), test-based assessments of adolescents’ functional, interactive, and critical HL, in an adult sample. Methods: One item from the AAHL-Adolescent item bank was modified to be more appropriate for an adult sample. Adults (n=2346) completed a measurement battery that included the HL item bank (12 functional, 15 interactive, and 9 critical HL questions), Newest Vital Sign (NVS), Single-Item Literacy Scale (SILS), demographics, and questions about HL-related behaviors. The assessments were evaluated and validated using Rasch measurement models. Convergent and criterion validity were assessed. Results: The final 7-item functional, 10-item interactive, and 7-item critical HL assessments and their composite (24 items) fit their respective Rasch models. Item-level invariance was established for gender, ethnicity, education, and age across all assessments. Differential item functioning for race was noted for two items on the interactive HL assessments. Good convergent validity with the NVS and SILS and good criterion validity with the HL-related behaviors were observed for all assessments. Conclusions The AAHL-Adult is the first test-based instrument validated in the U.S. that includes assessments for all three core qualities of HL. These assessments have utility across multiple settings, including public health program planning and evaluation, intervention development and evaluation, and clinical settings.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Current Studymentioning

confidence: 99%

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Validation of the Assessments of Adult Health Literacy: A Rasch Measurement Model Approach

Fleary

2023

Preprint

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“…Second, these participants were sampled using clusters, so the population may be under representative. However, because the Rasch analysis is sample-independent, this limitation is not as severe as with classical measurement theory [51] .…”

Section: Advantage and Limitationmentioning

confidence: 99%

Development and testing of physical activity literacy scales for elementary school students

zan

et al. 2023

Preprint

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Background: At this stage, Chinese research on physical activity literacy is still in its infancy, and the domestic primary school students' physical activity literacy assessment questionnaire is also in a state of development. In this study, a set of questionnaire scales for measuring the physical activity literacy of primary school students was compiled according to the characteristics of primary school students in different school stages, and the population measurement was carried out by using this scale, and then the accuracy of the scale and the fit according to the Rasch model were judged. Methods: We compiled a set of scales for measuring the physical activity literacy of primary school students, and directly distributed the questionnaires to primary school students in four regions of Hebei Province, Sichuan Province, Shenzhen City and Qinghai Province for actual measurement. We also used Rasch analysis to study the single-dimensionality, reliability, resolution and fitting degree of the questionnaire to judge the accuracy of the scale, aiming to provide a strong reference for the subsequent revision and wide application of the questionnaire. Results: The item reliability coefficient of all questionnaires was 1, and the item separation degree was 16.08, 16.71 and 18.18, respectively, all of which were greater than 3, indicating that the internal consistency of the questionnaire was better and the students with different ability levels could be better distinguished. The one-dimensional hypothesis of the three questionnaires holds. The project-person figure shows that the difficulty of the questionnaire items can be well matched with the subject's ability level. The average values of Infit MNSQ and Outfit MNSQ in the questionnaire were between 0.5-1.5, and the overall fit was good, and the data were in good agreement with the ideal model. In the fitting statistics of a single entry, it was found that the three grade levels generally showed poor fitting on the questions of whether they should continue to exercise after injury, whether it was appropriate to be sedentary and inactive, whether weather with severe air pollution was suitable for outdoor sports, and motivation for sports tests and motivation to like challenges. In subsequent modifications, we will delete and improve these questions or modify the statements of these questions to appropriately increase the difficulty of the questions. Conclusion: The one-dimensional test passed, reliable and internally consistent of the questionnaire was high, the difficulty of the item and the matching degree of population ability were high, and the questionnaire fit the model well. The questionnaire as a whole can form a questionnaire on sports health literacy of primary school students with good reliability and validity.

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Health “Is Not Rocket Science”: The General, Nutritional, and Oral Health Literacy of Portuguese Adolescents

de Almeida,

Costa,

Rodríguez

et al. 2024

Global Perspectives on Children's Health Literacy

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Development and validation of assessments of adolescent health literacy: a Rasch measurement model approach

Cited by 12 publications

References 55 publications

Validation of the Assessments of Adult Health Literacy: A Rasch Measurement Model Approach

Validation of the Assessments of Adult Health Literacy: A Rasch Measurement Model Approach

Development and testing of physical activity literacy scales for elementary school students

Health “Is Not Rocket Science”: The General, Nutritional, and Oral Health Literacy of Portuguese Adolescents

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