Measuring Health Literacy in Romania: Validation of the HLS-EU-Q16 Survey Questionnaire

Coman, Madalina Adina; Forray, Alina Ioana; Broucke, Stephan Van den; Cherecheș, Răzvan Mircea

doi:10.3389/ijph.2022.1604272

Cited by 11 publications

(17 citation statements)

References 32 publications

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“…Factor 1 focuses on measuring active search, understanding, and use of information provided by health personnel, while factor 2 reflects the ability to judge information on self-care and disease prevention originating from media and friends. This finding contrasts with observations reported in other studies: in Spain, 19 the researchers found that the scale is unifactorial, while in Romania and Iceland four factors were identified, 20,21 and in Turkey, three. 22 These discrepancies indicate that the health literacy domains implicit in the scale do not manifest themselves equally between different cultures.…”

Section: Discussioncontrasting

confidence: 99%

“…When HLS-EU-Q16 was validated in our population, 12 out of 16 questions were retained, and, for this reason, the literacy scale in Mexico is referred to as HLS-EU-Q12M. Our results differ from those obtained in Spain, 19 Romania, 20 Iceland 21 and Turkey, 22 given that, when the questionnaire was applied to the general population in those countries, no question was eliminated. One possible explanation is that the questions that were eliminated were those with the highest percentages of "I don't know" answers.…”

Section: Discussioncontrasting

confidence: 65%

“…This percentage is higher in comparison with those of the validations in Spain (79.1%), Romania (59.6%) and Iceland (62.6%). [19][20][21] That is, data variability is explained to a greater extent by both factors and no information is lost.…”

Section: Discussionmentioning

confidence: 99%

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Validation of the health literacy scale in patients with hypertension in Mexico

García-Vera,

Doubova,

Sánchez-Arenas

et al. 2023

GMM

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Introduction:Health literacy integrates skills around health care. The measurement of health literacy is relevant for proposing improvement interventions. The European HLS-EU-Q16 scale allows to comprehensively evaluate health literacy, but its psychometric properties have not been assessed in Mexico. Objective: To validate the HLS-EU-Q16 scale in patients with hypertension in Mexico. Methods: A validation study of a measuring instrument was carried out. The construct was evaluated by means of factor analysis; internal consistency, using Cronbach's alpha; and test-retest reliability, using intraclass correlation coefficient (ICC). The information was collected by interviewing 349 patients with hypertension in a family medicine unit of the Mexican Institute of Social Security, from April to June 2022. Results: In 23.8% of the patients, health literacy was inadequate; in 44. 4%, problematic; and in 31.8%, sufficient. The scale was found to retain 12 items and two factors (HLS-EU-Q12M). Cronbach's alpha was 0.83, and ICC was 0.94. Conclusion: The HLS-EU-Q12M scale in Mexican Spanish is a valid instrument for assessing health literacy in adults with hypertension.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 65%

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Validation of the health literacy scale in patients with hypertension in Mexico

García-Vera,

Doubova,

Sánchez-Arenas

et al. 2023

GMM

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show abstract

“…Therefore, the HLS-EU-Q16 was developed based on the data of the 8 original HLS-EU countries [ 10 , 11 , 15 , 16 , 17 ] and further validated for two additional studies in CZ and HU [ 10 ], an Austrian study of adolescents [ 10 , 18 ] and an Austrian study on two groups of migrants [ 10 , 19 , 20 ]. Later studies validating or applying the instruments in further languages were published: in Swedish and Arabic [ 21 ], in Somali [ 22 ], in Arabi, Dari, and Somali [ 23 ], in Italian [ 24 , 25 ], in Indonesian [ 26 ], in Austrian German [ 27 ], in French [ 28 , 29 ], in Turkish [ 30 ], in Japanese [ 31 ], in Islandic [ 32 ], in Romanian [ 33 ], and in an adapted Q18 version in Malaysian [ 34 ].…”

Section: Methodsmentioning

confidence: 99%

Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS19-Q12 Instrument in Seventeen Countries

Link¹,

Straßmayr

Waldherr³

et al. 2022

IJERPH

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Background: For improving health literacy (HL) by national and international public health policy, measuring population HL by a comprehensive instrument is needed. A short instrument, the HLS19-Q12 based on the HLS-EU-Q47, was developed, translated, applied, and validated in 17 countries in the WHO European Region. Methods: For factorial validity/dimensionality, Cronbach alphas, confirmatory factor analysis (CFA), Rasch model (RM), and Partial Credit Model (PCM) were used. For discriminant validity, correlation analysis, and for concurrent predictive validity, linear regression analysis were carried out. Results: The Cronbach alpha coefficients are above 0.7. The fit indices for the single-factor CFAs indicate a good model fit. Some items show differential item functioning in certain country data sets. The regression analyses demonstrate an association of the HLS19-Q12 score with social determinants and selected consequences of HL. The HLS19-Q12 score correlates sufficiently highly (r ≥ 0.897) with the equivalent score for the HLS19-Q47 long form. Conclusions: The HLS19-Q12, based on a comprehensive understanding of HL, shows acceptable psychometric and validity characteristics for different languages, country contexts, and methods of data collection, and is suitable for measuring HL in general, national, adult populations. There are also indications for further improvement of the instrument.

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“…the HLS-EU-Q16 and the HLS-EU-Q6 (which consists of 16 respectively six items from the original HLS-EU-Q) [7]. The HLS-EU-Q16 has been translated into several languages and psychometrics tests show that the validity of most of the translated versions are satisfactory [8][9][10][11][12][13][14], only the Japanese version has shown weak validity [15]. Arabic is the sixth most common language worldwide [16] and the language that most migrants with a refugee background speak [17].…”

mentioning

confidence: 99%

Validity and reliability of the Arabic version of the HLS-EU-Q16 and HLS-EU-Q6 questionnaires

Bergman

Nilsson

Dahlberg

et al. 2022

Preprint

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Background: Health literacy is an important social determinant of health and affects the ability to make decisions and take action to manage one’s health. The purpose of this study was to psychometrically examine the Arabic versions of HLS-EU-Q16 and HLS-EU-Q6 and their response patterns among Arabic-speaking persons in Sweden. Methods: By convenience sampling from a variety of settings, a total of 335 participants were invited to participate. The participants completed a self-assessment of comprehensive health literacy by answering the Ar-HLS-EU-Q16 questionnaire, also including the six items for Ar-HLS-EU-Q6. Statistical analysis was guided by The COnsensus-based Standards for the selection of health Measurement Instruments. Floor/ceiling effects, construct and criterion validity, test-retest reliability and internal consistency reliability were analysed. Results: In total, 320 participants were included in the psychometric evaluation. Mean age was 42.1 (SD 12.5), 63 % (n=199) were females and 53% (n=169) had at least 10 years of education. No floor or ceiling effect were found for the Ar-HLS-EU-Q16 or Ar-HLS-EU-Q6. For both instruments, construct validity was confirmed in four out of five expected correlations (weak positive correlation to educational level, self-perceived health, and years in Sweden; moderate positive correlation with higher sum score on the Arabic electronic health literacy scale, and strong positive correlation to higher Ar-HLS-EU-Q16/Ar-HLS-EU-Q6). Criterion validity showed poor agreement between the two questionnaires with a Cohen κ 0.58 (p<0.001). Test-retest reliability showed a substantial agreement, Cohen's κ for Ar-HLS-EU-Q16 and Ar-HLS-EU-Q6 were both 0.89. The internal consistency of both versions was acceptable, Cronbach alpha for Arabic-HLS-EU-Q16 was 0.91 and for Arabic-HLS-EU-Q6, 0.79. Split-half reliability was 0.95 and 0.78, respectively. Conclusion: The Arabic version of HLS-EU-Q16 shows good psychometric properties, validated in a Swedish setting. The findings can further inform and guide future validation studies in other settings worldwide. Furthermore, the results of the present study did not support criterion validity of Ar-HLS-EU-Q6.

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Measuring Health Literacy in Romania: Validation of the HLS-EU-Q16 Survey Questionnaire

Cited by 11 publications

References 32 publications

Validation of the health literacy scale in patients with hypertension in Mexico

Validation of the health literacy scale in patients with hypertension in Mexico

Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS19-Q12 Instrument in Seventeen Countries

Validity and reliability of the Arabic version of the HLS-EU-Q16 and HLS-EU-Q6 questionnaires

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