Structural properties and psychometric improvements of the Health Literacy Questionnaire in a Slovak population

TY - JOUR

T1 - Structural properties and psychometric improvements of the Health Literacy Questionnaire in a Slovak population

AU - Kolarcik, Peter

AU - Cepova, Eva

AU - Madarasova Geckova, Andrea

AU - Elsworth, Gerald R.

AU - Batterham, Roy W.

AU - Osborne, Richard H.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Objectives: Health literacy is an important determinant of health and health equity and therefore requires robust measurement. The aim was to examine the psychometric properties of the Slovak version of the Health Literacy Questionnaire (HLQ) including revised wording of response categories. Methods: A cross-sectional survey of the general Slovak adult population (N = 360, mean age 39) was conducted with the HLQ following its translation and cultural adaptation. Psychometric tests (confirmatory factor analysis, Cronbach’s alpha, composite reliability) and association (linear regression, ANOVA) with sociodemographic variables were undertaken. The performance of alternative version of response options were explored with the Mann–Whittney U test and item response theory. Results: A highly restrictive nine-factor confirmatory factor analysis showed acceptable fit [χ2WLSMV = 1684 (df = 866), p < 0.0001; CFI = 0.943, TLI = 0.938, RMSEA = 0.051, WRMR = 1.297] and reliability was acceptable (range 0.73–0.84). The revised response categories had a better distribution with lower average scores in three domains, compared with the original, and improved item information curves. Conclusions: The nine HLQ scales are robust, providing a fine-grained assessment of health literacy. The revised response options improve psychometric properties and are recommended for future studies.

AB - Objectives: Health literacy is an important determinant of health and health equity and therefore requires robust measurement. The aim was to examine the psychometric properties of the Slovak version of the Health Literacy Questionnaire (HLQ) including revised wording of response categories. Methods: A cross-sectional survey of the general Slovak adult population (N = 360, mean age 39) was conducted with the HLQ following its translation and cultural adaptation. Psychometric tests (confirmatory factor analysis, Cronbach’s alpha, composite reliability) and association (linear regression, ANOVA) with sociodemographic variables were undertaken. The performance of alternative version of response options were explored with the Mann–Whittney U test and item response theory. Results: A highly restrictive nine-factor confirmatory factor analysis showed acceptable fit [χ2WLSMV = 1684 (df = 866), p < 0.0001; CFI = 0.943, TLI = 0.938, RMSEA = 0.051, WRMR = 1.297] and reliability was acceptable (range 0.73–0.84). The revised response categories had a better distribution with lower average scores in three domains, compared with the original, and improved item information curves. Conclusions: The nine HLQ scales are robust, providing a fine-grained assessment of health literacy. The revised response options improve psychometric properties and are recommended for future studies.

KW - Cultural adaptation

KW - Health literacy

KW - Health Literacy Questionnaire (HLQ)

KW - Item response theory

KW - Measurement

KW - Psychometrics

UR - http://www.scopus.com/inward/record.url?scp=85014142673&partnerID=8YFLogxK

U2 - 10.1007/s00038-017-0945-x

DO - 10.1007/s00038-017-0945-x

M3 - Journal article

C2 - 28258403

AN - SCOPUS:85014142673

SN - 1661-8556

VL - 62

SP - 591

EP - 604

JO - International Journal of Public Health (Print Edition)

JF - International Journal of Public Health (Print Edition)

IS - 5

ER -