TY - JOUR
T1 - German translation, cultural adaptation, and validation of the Health Literacy Questionnaire (HLQ)
AU - Nolte, Sandra
AU - Osborne, Richard H.
AU - Dwinger, Sarah
AU - Elsworth, Gerald R.
AU - Conrad, Melanie L.
AU - Rose, Matthias
AU - Härter, Martin
AU - Dirmaier, Jörg
AU - Zill, Jördis M.
PY - 2017/2/24
Y1 - 2017/2/24
N2 - The Health Literacy Questionnaire (HLQ), developed in Australia in 2012 using a 'validitydriven' approach, has been rapidly adopted and is being applied in many countries and languages. It is a multidimensional measure comprising nine distinct domains that may be used for surveys, needs assessment, evaluation and outcomes assessment as well as for informing service improvement and the development of interventions. The aim of this paper is to describe the German translation of the HLQ and to present the results of the validation of the culturally adapted version. The HLQ comprises 44 items, which were translated and culturally adapted to the German context. This study uses data collected from a sample of 1,058 persons with chronic conditions. Statistical analyses include descriptive and confirmatory factor analyses. In one-factor congeneric models, all scales demonstrated good fit after few model adjustments. In a single, highly restrictive nine-factor model (no cross-loadings, no correlated errors) replication of the original English-language version was achieved with fit indices and psychometric properties similar to the original HLQ. Reliability for all scales was excellent, with a Cronbach's Alpha of at least 0.77. High to very high correlations between some HLQ factors were observed, suggesting that higher order factors may be present. Our rigorous development and validation protocol, as well as strict adaptation processes, have generated a remarkable reproduction of the HLQ in German. The results of this validation provide evidence that the HLQ is robust and can be recommended for use in German-speaking populations.
AB - The Health Literacy Questionnaire (HLQ), developed in Australia in 2012 using a 'validitydriven' approach, has been rapidly adopted and is being applied in many countries and languages. It is a multidimensional measure comprising nine distinct domains that may be used for surveys, needs assessment, evaluation and outcomes assessment as well as for informing service improvement and the development of interventions. The aim of this paper is to describe the German translation of the HLQ and to present the results of the validation of the culturally adapted version. The HLQ comprises 44 items, which were translated and culturally adapted to the German context. This study uses data collected from a sample of 1,058 persons with chronic conditions. Statistical analyses include descriptive and confirmatory factor analyses. In one-factor congeneric models, all scales demonstrated good fit after few model adjustments. In a single, highly restrictive nine-factor model (no cross-loadings, no correlated errors) replication of the original English-language version was achieved with fit indices and psychometric properties similar to the original HLQ. Reliability for all scales was excellent, with a Cronbach's Alpha of at least 0.77. High to very high correlations between some HLQ factors were observed, suggesting that higher order factors may be present. Our rigorous development and validation protocol, as well as strict adaptation processes, have generated a remarkable reproduction of the HLQ in German. The results of this validation provide evidence that the HLQ is robust and can be recommended for use in German-speaking populations.
UR - http://www.scopus.com/inward/record.url?scp=85013997242&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0172340
DO - 10.1371/journal.pone.0172340
M3 - Journal article
C2 - 28234987
AN - SCOPUS:85013997242
SN - 1932-6203
VL - 12
SP - 1
EP - 12
JO - PLoS Computational Biology
JF - PLoS Computational Biology
IS - 2
M1 - e0172340
ER -