Development and Validation of the Chinese Health Literacy Scale for Chronic Care

Leung, Angela Yee Man; Cheung, Mike K. T.; Lou, VW; Chan, Felix Hon Wai; Ho, Celina Kit Yee; Ling, Tsui; Chan, Sophia Siu Chee; Chi, Iris

doi:10.1080/10810730.2013.829138

Cited by 34 publications

(33 citation statements)

References 51 publications

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“…With regards to the psychometric properties of the HL measures, the majority of measures ( n = 83, 89%) used analysis consistent with Classical Test Theory (CTT) for reliability testing and/or item reduction, while a small but growing number reported using analysis consistent with newer advanced approaches such as Rasch and Item Response Theory (IRT) either alone or adjunctively( n = 16, 15%) with CTT [4,27,28,39,47,52,54,56,61,62,64,67,78,101,108]. The reported reliability was generally strong across most measures (Cronbach’s a or KR-20 = 0.70–0.98), with the exception of a few measures [64,65,81,107].…”

Section: Resultsmentioning

confidence: 99%

State of the science of health literacy measures: Validity implications for minority populations

Nguyen

Park

Han

et al. 2015

Patient Education and Counseling

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Objectives To review the evidence supporting the validity of health literacy (HL) measures for ethnic minority populations. Methods PubMed, CINAHL, and PsycINFO databases were searched for HL measures between 1965 and 2013. Results A total of 109HL measures were identified; 37 were non-English HL measures and 72 were English language measures. Of the 72 English language measures, 17 did not specify the racial/ethnic characteristic of their sample. Of the remaining 55 measures, 10 (18%) did not include blacks, 30 (55%) did not include Hispanics, and 35 (64%) did not include Asians in their validation sample. When Hispanic and Asian Americans were included, they accounted for small percentages in the overall sample. Between 2005–2013, a growing number of REALM and TOFHLA translations were identified, and new HL measures for specific cultural/linguistic groups within and outside the United States were developed. Conclusions While there are a growing number of new and translated HL measures for minority populations, many existing HL measures have not been properly validated for minority groups. Practice Implications HL measures that have not been properly validated for a given population should be piloted before wider use. In addition, improving HL instrument development/validation methods are imperative to increase the validity of these measures for minority populations.

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Section: Resultsmentioning

confidence: 99%

State of the science of health literacy measures: Validity implications for minority populations

Nguyen

Park

Han

et al. 2015

Patient Education and Counseling

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“…Week 10. Demographics which included sex, age, marital status, educational level, and employment status, districts in which they lived in, living status, health literacy (measured by the Chinese Health Literacy Scale for Chronic Care (CHLCC) [22]) and types of chronic illnesses were collected. The internal consistency of CHLCC, measured by Cronbach's alpha, was 0.91 [22].…”

Section: Outcomes and Assessmentmentioning

confidence: 99%

Motivating Diabetic and Hypertensive Patients to Engage in Regular Physical Activity: A Multi-Component Intervention Derived from the Concept of Photovoice

Leung¹,

Chau²,

Leung³

et al. 2019

Preprint

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Aims: A community-based multi-component intervention (increasing awareness of the importance of physical activity in chronic illness management through reading comic books, training regarding warm-up stretching exercises, identifying facilitators and barriers to exercise through photosharing, supporting self-reflection and development of action plans) was developed to promote physical activity (PA) among patients with diabetes and hypertension. This study aimed to evaluate the efficacy of this intervention on health behaviour (walking) and health outcomes. Design: A non-randomized controlled trial with waitlisted control and pre- and post-measures. Setting: Community centres for the elderly. Participants: A total of 204 older adults with diabetes and/or hypertension were recruited. They were assigned to either the intervention group (IG) or waitlisted to the control group (CG). Intervention: Under the supervision of a nurse, six weekly group meetings were arranged in community centres for the elderly in which the participants freely exchanged their views regarding the barriers and facilitators of regular physical activity. Participants were encouraged to take photos in their neighbourhood or at home and brought these photos to share at the group meetings. The photos showed both the barriers and the facilitators to PA. In the last meeting, each participant worked out a plan to perform PA in the coming four weeks. Measures: PA referred to the number of steps taken per day and it was measured by a Garmin Accelerometer at baseline, Week 6 and Week 10. Other measures included the nine-item Self-Efficacy Scale for Exercise - Chinese version (SEE-C), the 23-item Chinese Barriers to Exercise Scale and Senior Fitness Tests. Generalised Estimating Equations (GEE) models compared the outcomes over time between IG and CG. Results: A statistically significant difference in the changes in the average number of steps taken daily between the two groups at Week 10 (mean difference = 965.4; 95% confidence interval: 92.2, 1838.6, p = 0.030) was observed, although the difference at Week 6 was non-significant (mean difference = 777.6; 95% confidence interval: −35.3, 1590.5, p = 0.061). IG participants also showed significant improvements in lower body strength (mean difference = 0.967; 95% confidence interval: 0.029, 1.904, p = 0.043) and lower limb flexibility (mean difference = 2.068; 95% confidence interval: 0.404, 3.731, p = 0.015) at Week 10 compared to CG participants. Conclusion: This multi-component intervention improved the participants’ physical activity level and physical fitness, particularly in lower limb flexibility and body strength.

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“…There were 3 MMAS levels: MMAS level 1 referred to the MMAS score lower than 6, indicating 'poor adherence'; MMAS level 2 referred to the MMAS score 6 to 7, indicating 'medium adherence', and MMAS level 3 referred to MMAS score 8, indicating high adherence. Health literacy was measured by the 24-item Chinese Health Literacy for Chronic Care (CHLCC) [15]. The total CHLCC score ranged from 0 to 48.…”

Section: Methodsmentioning

confidence: 99%

Supporting Older Adults with Mild Cognitive Impairment in Medication Taking: A 2-year Longitudinal Study

Leung¹,

Lo²,

Leung³

et al. 2017

Neuropsychiatry

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Objective:Community dwelling older adults with mild cognitive impairment (MCI) encounter challenges in many daily activities including medication taking. With inadequate health literacy, many of them have difficulty in understanding the instructions on drug labels and make decision on medication taking. This study aims to assess the effect of two interventions, verbal advice plus educational leaflet (VAEL) and comic books (CB), on medication taking among persons with MCI. Methods:This is a two-year multi-site longitudinal study with pre-and-post design and four-point measures (Time 1, 2, 3, and 4). Subjects were aged 60 or above, scored <22 in Chinese version of the Montreal Cognitive Assessment (MoCA), and were taking ≥ 2 drugs regularly. Health literacy was measured by the 24-item Chinese Health Literacy for Chronic Care (CHLCC) and medication adherence was measured by the 8-item Morisky Medication Adherence Scale (MMAS). Generalized Linear Mixed Models (GLMM) and Generalized Estimating Equation (GEE) were used. Results:Among the 131 subjects, the majority (62%) were females and mean age was 82.5 (SD 6.5). One-third of them received primary education (31%). Controlling age, there was a significant increase in CHLCC scores after the use of CBs (T4-T3: coefficient=2.742, p=0.003; T4-T1: coefficient=5.073, p=0.014). On the other hand, comparing to the baseline at T1 and controlling age, the chance of moving MMAS level one level higher than its original level at T4 was high (O.R.=3.316, S.E. 0.2979, 95% CI 0.650-1.747, p<0.001). Similar improvement in MMAS level was observed at T3 and T2. Conclusion:The two interventions (VAEL and CBs) seem to be a good strategy to improve health literacy and medication adherence among community dwellers with MCI. More research is warranted to support medication taking in this specific population.

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Development and Validation of the Chinese Health Literacy Scale for Chronic Care

Cited by 34 publications

References 51 publications

State of the science of health literacy measures: Validity implications for minority populations

State of the science of health literacy measures: Validity implications for minority populations

Motivating Diabetic and Hypertensive Patients to Engage in Regular Physical Activity: A Multi-Component Intervention Derived from the Concept of Photovoice

Supporting Older Adults with Mild Cognitive Impairment in Medication Taking: A 2-year Longitudinal Study

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