Applicability of Internationally Available Health Literacy Measures in the Netherlands

Abstract

Health literacy measures for use in clinical-epidemiological research have all been developed outside Europe. In the absence of validated Dutch measures, we evaluated the cross-cultural applicability of the Rapid Estimate of Adult Literacy in Medicine (REALM), the Newest Vital Sign (NVS), the Set of Brief Screening Questions (SBSQ), and the measure of Functional Communicative and Critical Health Literacy (FCCHL). Each measure was translated into Dutch following standardized procedures. We assessed feasibility, internal consistency, and construct validity among patients with coronary artery disease (n = 201) and patients with diabetes type 2 (n = 88). Patients expressed most problems in responding to the NVS-D. They were not familiar with the type of food label and had difficulties calculating in portions instead of grams. The FCCHL-D items seemed too theoretical for many patients. Cronbach's alpha was acceptable for all measures. Correlation patterns between the measures were moderately coherent with a priori hypotheses. All translated measures were able to distinguish between high- and low-educated groups of patients, with the NVS-D performing best. Despite reasonable psychometric properties as demonstrated so far, these measures need to be further developed in order to increase applicability for assessing health literacy in clinical-epidemiological research in the Netherlands.

Public Health Citizen Science; Perceived Impacts on Citizen Scientists: A Case Study in a Low-Income Neighbourhood in the Netherlands

“…Items included personal data, two visual analogue scales rating personal and neighbourhood health (de Boer et al 2004), the Chew Three-item Health Literacy (HL) scale, Dutch version (Fransen et al 2011), and the 13 item Sense Of Coherence (SOC) scale (Dutch version) (Swan et al 2015). The Chew HL scale measures functional literacy level needed to understand written health information by means of three five-point Likert scale questions.…”

“…Responses for the HL scale were scored from 0 to 4, added, and averaged. An average score ≥2 indicates adequate HL; scores under 2 indicate inadequate HL (Fransen et al 2011). Scores on SOC were calculated by adding up the points (1-7) marked for each item.…”

Preferences for genetic testing for colorectal cancer within a population-based screening program: a discrete choice experiment

“…Health literacy was measured by three validated Dutch questions of the Set of Brief Screening Questions. 32 Participants scored these questions on a five-point Likert scale, from zero to four. An average score of ≤ 2 indicates inadequate health literacy, while an average score 42 indicates adequate health literacy.…”

“…An average score of ≤ 2 indicates inadequate health literacy, while an average score 42 indicates adequate health literacy. 32 Furthermore, questions pertained to information on experience with other national cancer screening programs, experience with genetic screening and family cancer history. Respondents were asked to indicate to what extent they agreed or disagreed with several theorems about their attitude, social norm, self-efficacy and intention towards genetic screening for CRC.…”

Use and effects of patient online access to medical records in general practice through a personal health record in the Netherlands. A protocol for a mixed methods study. (Preprint)

“…In addition items will be included to assess level of education; self perceived skills for using internet. We will assess self-perceived health with a frequently used indicator in the [56,57]. The base-line questionnaire has been piloted which has resulted in adjusting of the wording of two self-generated questions.…”