Development of the Health Literacy Assessment Scale for Adolescents (HAS-A)

Abstract

Background Health literacy has been found to be a crucial component of successful communication and navigation in health care. Various tools have been developed to measure health literacy skills, but few have been developed specifically for adolescents, and most require in-person administration. This study sought to develop a self-report health literacy scale for adolescents to assess four key health literacy domains: the ability to obtain, communicate, understand, and process health information. Methods We collected data from 272 youth aged 12–19 recruited from a pediatrics clinic (37%) and the community (63%). We administered the Rapid Estimate of Adolescent Literacy in Medicine-Teen, Newest Vital Sign, and three surveys, and used factor analysis to identify scale items. Results Using multiple health literacy assessments, it was clear that many teens struggle with low health literacy skills. When identifying items that can be used as self-report items in future research, factor analysis identified three subscales; a 5-item communication scale (alpha = 0.77), a 4-item confusion scale (alpha = 0.73), and a 6-item functional health literacy scale (alpha = 0.76). The scales performed reasonably well when compared with validation items. Conclusions Self-report items can be used to assess health literacy skills for adolescents when in-person administration is not possible or feasible. Such items will allow for greater study of how health literacy impacts communication in not only health care settings, but for all levels of health communication. The tool will also allow researchers to better understand how adolescent health literacy is related to a variety of health outcomes. Further testing of these scales with different populations is warranted.

Validation of the Rapid Estimate for Adolescent Literacy in Medicine Short Form (REALM-TeenS)

“…Development data came from 2 sources: a study conducted in New York (sample 1) to develop a self-report health literacy measurement tool 11 and a project Ohio (sample 2) studying adolescent health literacy and transition readiness. 15 A total of 665 youth 12 to 19 years of age were included.…”

“…Youth were recruited through a pediatrics clinic at a teaching hospital (37%) and from the community (63%) through organizations and schools, flyers, and word-of-mouth. 11 The average age of the sample was 15.6 years (range, 12-19 years). A majority of the participants were female (63%) and 93% were born in the United States.…”

Health literacy of children and adolescents

“…Velikost výzkumného souboru se pohybovala od 47 respondentů až po 162 209 respondentů. Některé studie byly zaměřené na obecnou populaci dětí a adolescentů [7,9,10,[14][15][16][18][19][20]. Jiné směřovaly k dětem a adolescentům se specifickými zdravotními či sociálními problémy: adolescenti užívající trvale medikaci [6], adolescenti v nápravných zařízeních [8], děti a adolescenti trpící nadváhou či obezitou [11,13,22], děti trpící jakýmkoliv chronickým onemocněním [12]…”

“…Sběr dat probíhal jednak v prostředí základních a středních škol za spolupráce vyškolených pedagogických pracovníků [9,10,13,14,18,19,23,24], ve zdravotnických zařízeních [6,11,15,16,21], přímo v komunitě [8,16,20]. V ostatních analyzovaných studiích nebyl způsob sběru popsán.…”

“…K hodnocení zdravotní gramotnosti byly použity převážně standardizované hodnoticí techniky, méně pak hodnoticí techniky vlastní konstrukce. Nejčastěji byl použit REALM nebo REALM-Teen hodnoticí nástroj [6,8,12,15,16,20,21] samostatně nebo v kombinaci s TOFHLA nebo NVS. REALM-Teen je hodnoticím nástrojem, který zahrnuje schopnost rozpoznávání čtení 66 zdravotních pojmů, které jsou umístěny ve 3 sloupcích ve vzestupném pořadí obtížnosti.…”