Use of the English Health Literacy Questionnaire (HLQ) with Health Science University Students in Nepal: A Validity Testing Study

Abstract

Research evidence shows that health literacy development is a key factor influencing non-communicable diseases care and patient outcomes. Healthcare professionals with strong health literacy skills are essential for providing quality care. We aimed to report the validation testing of the Health Literacy Questionnaire (HLQ) among health professional students in Nepal. A cross-sectional study was conducted with 419 health sciences students using the HLQ in Nepal. Validation testing and reporting were conducted using five sources outlined by ‘the 2014 Standards for Educational and Psychological Testing’. The average difficulty was lowest (17.4%) for Scale 4. Social support for health, and highest (51.9%) for Scale 6. Ability to actively engage with healthcare providers. One factor Confirmatory Factor Analysis (CFA) model showed a good fit for Scale 2, Scale 7 and Scale 9 and a reasonable fit for Scale 3 and Scale 4. The restricted nine-factor CFA model showed a satisfactory level of fit. The use of HLQ is seen to be meaningful in Nepal and warrants translation into native Nepali and other dominant local languages with careful consideration of cultural appropriateness using cognitive interviews.

Digital Health Literacy as a Predictor of Awareness, Engagement, and Use of a National Web-Based Personal Health Record: Population-Based Survey Study

“…The unidimensionality of each scale was established with evidence of satisfactory fit for each of the nine 1-factor models, and composite reliability of each scale ranged from 0.77 to 0.90 [41]. Validity evidence for the English version was further confirmed in subsequent validation studies in Australia [43,47,52,53], the English version in other contexts [54] and elsewhere [44][45][46][55][56][57], confirming that the HLQ scales can be used independently to measure different dimensions of health literacy.…”

Health Literacy Development among People with Chronic Diseases: Advancing the State of the Art and Learning from International Practices

“…Budhatoki et al [ 15 ] provide an argument for valid health literacy measurements as the foundation for any evidence-based approach to identifying health literacy needs, and based on that, developing suitable interventions in their validity testing study “Use of the English Health Literacy Questionnaire (HLQ) with Health Science University Students in Nepal”. As the case of Nepali health science students illustrates, identifying the health literacy of (future) healthcare professionals is so important because only when individuals working in healthcare institutions are aware of their own health literacy resources can they better understand how to meaningfully support the health literacy of the people they serve.…”

Cultural Adaptation and Validity Testing of the Portuguese Version of the Health Literacy Questionnaire (HLQ)

“…The HLQ has been shown to have robust psychometric properties in its original version [ 21 , 22 ], as well as across European cultures [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ] and in some Asian and African cultures [ 32 , 33 , 34 ], supporting the initial nine-factor model and thus confirming its construct validity for use in a variety of settings. To allow assessment in communities and across specific populations with the aim of adaptation of services and structures to the health needs of people struggling with disease management or prevention, the HLQ has been translated and undergone validity testing in different countries and underlies the work done in the scope of the WHO National Health Literacy Demonstration Projects, in which Portugal is involved [ 10 ].…”

“…The Portuguese version of the HLQ demonstrated satisfactory reliability ranging from 0.74 to 0.83, which is consistent with the scores found in previous studies with the HLQ, namely the Brazilian (0.67 to 0.82) [ 23 ], Danish (0.77–0.87) [ 24 ], Slovak (0.73 to 0.84) [ 25 ], French (0.77 to 0.91) [ 26 ], German (0.77 to 0.91) [ 27 ], Norwegian (0.71 to 0.87) [ 28 ], Dutch (0.83 to 0.94) [ 29 ], Urdu (0.84 to 0.91) [ 32 ], Ghanaian (0.66 to 0.82) [ 33 ] Nepalese studies (0.74 to 0.88) [ 34 ].…”