Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021

Abstract

Background It has been about 30 years since the first health literacy instrument was developed. This study aimed to review all existing instruments to summarize the current knowledge on the development of existing measurement instruments and their possible translation and validation in other languages different from the original languages. Methods The review was conducted using PubMed, Web of Science, Scopus, and Google Scholar on all published papers on health literacy instrument development and psychometric properties in English biomedical journals from 1993 to the end of 2021. Results The findings were summarized and synthesized on several headings, including general instruments, condition specific health literacy instruments (disease & content), population- specific instruments, and electronic health. Overall, 4848 citations were retrieved. After removing duplicates (n = 2336) and non-related papers (n = 2175), 361 studies (162 papers introducing an instrument and 199 papers reporting translation and psychometric properties of an original instrument) were selected for the final review. The original instruments included 39 general health literacy instruments, 90 condition specific (disease or content) health literacy instruments, 22 population- specific instruments, and 11 electronic health literacy instruments. Almost all papers reported reliability and validity, and the findings indicated that most existing health literacy instruments benefit from some relatively good psychometric properties. Conclusion This review highlighted that there were more than enough instruments for measuring health literacy. In addition, we found that a number of instruments did not report psychometric properties sufficiently. However, evidence suggest that well developed instruments and those reported adequate measures of validation could be helpful if appropriately selected based on objectives of a given study. Perhaps an authorized institution such as World Health Organization should take responsibility and provide a clear guideline for measuring health literacy as appropriate.

Development and psychometric properties of a tool to assess Media Health Literacy (MeHLit)

“…MeHLit is a valid and reliable assessment tool to measure media health literacy regarding individuals’ skills to assess health-related messages which will be received by noticing the goal of, type of content, meaning, appearance, and audience of a message. Each of the two concepts of health literacy [ 36 ] and media literacy [ 6 , 37 – 39 ] have been measured separately through different instruments. Based on our knowledge, so far no specific tool has been found to measure media literacy and health.…”

Understanding Health Literacy among University Health Science Students of Different Nationalities

“…According to that definition, health literacy requires four competences: obtaining, understanding, processing, and applying information [ 10 ]. To measure the level of health literacy, several instruments have been created [ 11 , 12 , 13 ], some of which provide subjective information, while others provide objective or functional measurements. These tools involve questions related to the health status, access to information, and tasks that assess basic literacy and numeracy.…”

Development and psychometric analysis of a new tool to assess food literacy in diabetic patients

“…Interactive health literacy means having the ability to communicate and interact and find information. And critical health literacy means critical evaluation of information [ 13 , 23 , 33 ]. The factors explored in the present study correspond to the mentioned dimensions.…”

“…Factors that affect a diabetic patient's self-care behavior include food literacy and following a healthy diet [12]. Previous studies on food literacy have not focused on the effects of healthy diets, but have only taken general health literacy into account [3,[13][14][15]. Although there has been an increase in studies carried out in this field, there has been limited progress due to the lack of an accepted method for measuring food literacy.…”