Evaluation of cross‐cultural adaptation and validation of the Persian version of the health literacy for school‐aged children scale: Methodological study

Abstract

Background and AimsHealth literacy (HL) is an essential determinant of health in children. Inadequate HL causes problems for individuals and society, such as more hospitalizations, medication errors, poor health, and higher mortality and health care costs. A valid and reliable scale is needed to measure this population's HL. This study evaluated the cross‐cultural adaptation and validation of the Persian version of the HL for School‐Aged Children (HLSAC) Scale.MethodsIn this methodological research, the HL scale of school‐aged children was translated from English to Persian using the Backward–Forward translation protocol. The content validity, face validity, construct validity (Exploratory Factor Analysis [EFA] and Confirmatory factor analysis [CFA]), plus reliability, were evaluated by Internal consistency and stability methods. Two hundred forty samples from south of Tehran were selected by multi‐stage sampling method to assess the construct validity. Data analysis was performed using SPSS v24 and Jamovi v2.2.ResultsA qualitative evaluation of face and content validity showed that experts and the target group approved all items on the scale. The results of EFA indicated the existence of one factor, explaining 47.17% of the total variance of the scale. The CFA results showed that the one‐factor model of the Persian version of the HL scale for children is almost acceptable. (χ2/df = 2.94, Root Mean Square Error of Approximation = 0.09, Normed‐Fit Index = 0.89, Tucker‐Lewis Index = 0.89, Comparative Fit Index = 0.92). Cronbach's alpha coefficient for the whole scale was 0.80, and the Intraclass Correlation Coefficient value for the whole scale was calculated as 0.78 using the single‐rating, absolute‐agreement, 2‐way mixed‐effects method.ConclusionThe study validates the HLSAC Scale, affirming its suitability for assessing HL in Persian‐speaking child populations.