Self‐administered health literacy instruments for people with diabetes: systematic review of measurement properties

Abstract

With the current evidence, the Health Literacy Scale may be the most appropriate instrument for patients with diabetes in practice and research. However, the structural validity of this scale needs to be further established, particularly in other language versions. It is also recommended to use the Diabetes Numeracy Test-15 along with the Health Literacy Scale to complement the lack of numeracy measures in the Health Literacy Scale.

Relationships of health literacy to self‐care behaviors in people with diabetes aged 60 and above: Empowerment as a mediator

“…Lee et al. () conducted a systematic review of the psychometric properties of diabetes‐specific health literacy instruments and found that based on the current evidence, the HLS is the most appropriate instrument for measuring diabetes‐specific health literacy. However, since the HLS does not include a numeracy component, they suggested using a scale with a numeracy measure such as the Diabetes Numeracy Test‐15 (Huizinga et al., ), which should be addressed in a future study.…”

“…The HLS score was computed as the average for all items, with a higher score indicating better health literacy. This study used the Korean version of the HLS that exhibits internal consistency reliability, factorial construct validity and known‐groups validity in Korean people with diabetes (Lee et al., ). Cronbach's alpha for the scale used in the present study was 0.92.…”

“…A research assistant met those potential participants who initially agreed to participate and explained the purpose of the study to them. Those potential participants who subsequently agreed to participate were asked to sign an informed-consent form and complete questionnaires: the Health Literacy Scale (HLS; Lee, Kim, Lee, & Moon, 2017), the Diabetes Empowerment Scale-28 (DES-28; Anderson, Funnell, Fitzgerald, & Marrero, 2000), the Summary of Diabetes Self-Care Activities (SDSCA; Lee et al, 2016) and a questionnaire that collected demographic information and asked the participants about whether or not they had ever received diabetes education.…”

The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis

“…A possible explanation is the variety of definitions and measurements of health literacy. 12,13 In clinical settings, health literacy has been traditionally assessed with word recognition tests like the Rapid Estimate of Adult Literacy in Medicine (REALM 12 ) or combined health literacy and numeracy tests like the Short Test of Functional Health Literacy (S-TOFHLA 13 ). These tests measure patients' performance, i.e., basic comprehension, reading, and numeracy skills.…”

A New Objective Health Numeracy Test for Patients with Type 2 Diabetes: Development and Evaluation of Psychometric Properties

“…The third issue is related to the lack of psychometric properties. In accordance with a systematic review of measurement properties [16], three objective instruments have been developed for assessing health numeracy for patients with diabetes: diabetes numeracy test-43 (DNT-43) [4], its short-form DNT-15 [17], and brief numeracy [18]. As the results of the systematic review [16], these instruments had no, unclear, or only limited evidence for most of their psychometric properties, implying the need for a new objective instrument measuring health numeracy for patients with diabetes.…”