Iranian Health Literacy Questionnaire (IHLQ): An Instrument for Measuring Health Literacy in Iran

Abstract

Background: Promoting Health Literacy (HL) is considered as an important goal in strategic plans of many countries. In spite of the necessity for access to valid, reliable and native HL instruments, the number of such instruments in the Persian language is scarce. Moreover, there is no good estimation of HL status in Iran. Objectives: The aim of this study was to provide a valid, reliable and native instrument to measure and monitor community HL in Iran and also, to provide an estimation of HL status in two Iranian provinces. Patients and Methods: By applying the multistage cluster sampling, 1080 respondents (540 from each gender) were recruited from Kerman and Mazandaran provinces of Iran, from February to June 2014 to participate in this cross-sectional study. The development of the Iranian Health Literacy Questionnaire (IHLQ) was initiated with a comprehensive review of the literature. Then, face, content and construct validity as well as reliability were determined. Results: Internal consistency and test-retest reliability (ICC) of the factors was in the range of 0.71 to 0.96 and 0.73 to 0.86, respectively. In order to construct validity, Exploratory Factor Analysis (EFA) Kaiser-Meyer-Olkin (KMO) = 0.95 and Bartlett's test result of 3.017 with P < 0.001) with varimax rotation was used. Optimal reduced solution, including 36 items and seven factors, was found in EFA. Five of the factors identified were reading/comprehension skills, individual empowerment, communication/decision-making skills, social empowerment and health knowledge. Conclusions: It was concluded that IHLQ might be a practical and useful tool for investigating HL for Persian language speakers around the world. Since HL is dynamic and its instruments should be regularly revised, further studies are recommended to assess HL with application of IHLQ to detect its potential imperfections.

Health literacy among Iranian adults: findings from a nationwide population-based survey in 2015

“…This questionnaire has 53 items in 9 domains: health information access (5 items), health information use (6 items), reading skills (5 items), comprehension skills (8 items), interpretation/judgment skills (6 items), communication and decision-making skills (8 items), health knowledge (5 items), individual empowerment (6 items), and social empowerment (4 items). In a previous study, in which we validated our questionnaire, the Kaiser-Meyer-Olkin coefficient was 0.95, Bartlett's test for sphericity was statistically significant (P < 0.001) and Cronbach's alpha was > 0.7 (0.71-0.96) (17). The intraclass coefficient for each construct varied between 0.60 and 0.81.…”

“…Data were collected using the IHLQ (17). This questionnaire has 53 items in 9 domains: health information access (5 items), health information use (6 items), reading skills (5 items), comprehension skills (8 items), interpretation/judgment skills (6 items), communication and decision-making skills (8 items), health knowledge (5 items), individual empowerment (6 items), and social empowerment (4 items).…”

“…Therefore, our study aimed to determine the level of health literacy in the Islamic Republic of Iran, and in particular to address the existing gaps and limitations in the literature. Using the validated Iranian Health Literacy Questionnaire (IHLQ) (17), we aimed to assess all of the important domains of health literacy and factors associated with health literacy in the urban and rural adult population across 9 major provinces.…”

Construct Validation of the Health Literacy Questionnaire (HLQ) in Shahrekord Cohort Study, Iran

“…Health literacy is considered to be a key factor in the selfmanagement and performance of healthy behaviors [1]. The efficacy of educational programs and health promotion is strongly influenced by health literacy [2]. According to the World Health Organization (WHO), health literacy is defined as the cognitive and social skills that determine the motivation and ability of individuals to access and comprehend information for the promotion and maintenance of health [3].…”

“…However, few studies have been conducted to develop a health literacy questionnaire involving the measurement of its validity and reliability. For instance, Haghdoost et al (2015) conducted a study in Kerman and Mazandaran provinces (Iran) to develop a valid and reliable questionnaire to investigate health literacy in Iranians, which is known as the Iranian health literacy questionnaire (IHLQ) [2]. In another study, the eHEALS questionnaire was validated in the students at Yazd University of Medical Sciences (Iran) [13].…”