Development and validation of the high blood pressure-focused health literacy scale

Abstract

Objective While the role of health literacy in chronic disease management is well documented, few intervention studies have been reported. A major barrier to designing and implementing such interventions is the lack of valid health literacy tools. This study developed and tested a novel health literacy scale for individuals with high blood pressure (HBP). Methods A two-step design process was used: In the construction phase, focus group studies and a literature review were conducted to generate a pool of items. The testing phase involved a psychometric evaluation and pilot-testing of the scale on hypertensive Korean Americans (n=386). The end product was a HBP-health literacy scale (HBP-HLS) with two essential domains, print literacy and functional health literacy. Results Psychometric testing indicated that the scale was reliable (Kuder-Richardson-20 coefficient=0.98), valid (content validity index ≥0.8), and significantly correlated with theoretically selected variables (education, r=0.67, p<0.01; HBP knowledge, r= 0.33, p<0.01). Conclusion The HBP-HLS demonstrated its utility for evaluating HBP management interventions in the community setting. Practice Implications: Utilizing the HBP-HLS should be considered as a potential tool for improving health literacy and evaluating intervention studies in the context of HBP management.

An Introduction to Item Response Theory for Patient-Reported Outcome Measurement

“…Briefly, the HBP-HLS is a 43-item measure that assesses health literacy (HL) in the context of high blood pressure, targeting those with limited English proficiency [45]. Each item is scored as correct or incorrect.…”

Prevalence and Predictors of Depression in Korean American Elderly: Findings from the Memory and Aging Study of Koreans (MASK)

“…Numbering more than 1.3 million individuals in 2008 (3.4% of the older US population), this group is projected to grow to more than 7.6 million (8.6% of the older population) by 2050. 1 The demand for effective care support systems for community-dwelling elderly is ubiquitous; however, elderly Asian immigrants, including Korean American elderly (KAE), often face additional barriers to accessing culturally and contextually relevant care support systems within the community: As predominantly first-generation immigrants, they must deal with the consequences of acculturative stress, 2 less-than-optimal health literacy, 3 and insufficient care support infrastructures in their neighborhoods. 4 …”

Development and Validation of the Assessment of Health Literacy in Breast and Cervical Cancer Screening

“…Traditional health education programs involving individuals with low health literacy have primarily focused on adjusting the reading levels, using interpreters, or incorporating the use of video, audiotapes, or web-based decision aids (McCray, 2005; Bischoff, Perneger, Bovier, Loutan, & Stalder; 2003; Santo, Laizner, & Shohet, 2005; Miller et al, 2011). Few have included topic contents or activities that are directly focused on improving health literacy due, in part, to the lack of a sensitive instrument to measure health literacy (Kim et al, 2012). The AHL-C may be a useful evaluation tool for clinicians and researchers who work with populations in need of improving cancer screening health literacy.…”

“…Assessing health literacy within a specific context has been a growing trend. For example, the following context specific health literacy tools have been developed: the Literacy Assessment for Diabetes (Nath, Sylvester, Yasek, & Gunel, 2001), Diabetes Numeracy Test (Huizinga et al, 2008), Asthma Numeracy Questionnaire (Apter et al, 2006), Rapid Estimate of Adult Literacy in Genetics (REAL-G) (Erby, Roter, Larson, & Cho, 2008), High Blood Pressure-Focused Health Literacy Scale (Kim et al, 2012), and HIV-Related Health Literacy Scale (HIV-HL) (Ownby et al, 2013). …”