scholarly journals Describing progression of health literacy skills: Establishing the HLS-Q12 cut-off scores

2019 ◽  
Author(s):  
Øystein Guttersrud ◽  
Christopher Le ◽  
Kjell Sverre Pettersen ◽  
Sølvi Helseth ◽  
Hanne Søberg Finbråten
Keyword(s):  
Health Literacy ◽  
Rating Scale ◽  
Short Form ◽  
Measurement Model ◽  
Literacy Skills ◽  
Health Claims ◽  
Polytomous Items ◽  
Confirmatory Factor Analyses ◽  
Threats To Validity ◽  
Rasch Modelling

Abstract Background The self-reported European Health Literacy Survey Questionnaire (HLS-EU-Q47) is a widely used health literacy measure. Based on confirmatory factor analyses and Rasch-modelling, the short form HLS-Q12 was developed to meet the Rasch unidimensional measurement model expectations. After its publication, there has been a worldwide call to identify HLS-Q12 cut-off scores and establish clearly delineated standards in terms of the skills assessed. This study therefore aims to identify the HLS-Q12 scores associated with statistically distinct levels of proficiency and construct a proficiency scale that expresses progression – what individuals typically know and can do at increasingly more sophisticated levels of health literacy. Methods We applied the unidimensional Rasch measurement model for polytomous items to responses from 900 randomly sampled individuals and 388 individuals with type 2 diabetes. Using Rasch-based item calibration, we constructed a proficiency scale by locating the ordered item thresholds along the scale; by applying Wright’s method for the maximum number of strata, we determined the cut-off scores for significantly different levels. By directly referring to item content that people who reached the cut-off scores view as ‘easy’, we could describe these gradually more advanced levels of health literacy. Results We identified statistically distinct levels of health literacy at the empirically identified cut-off scores 27, 33 and 39 and confirmed them by analysing the responses from individuals with diabetes. Individuals who reach these cumulative benchmarks of marginal, intermediate and advanced literacy can typically access, appraise and apply information relevant to stay healthy, improve health and critically judge health claims and compare treatments, respectively. Conclusions By revealing progression in health literacy, we extended the current models of health literacy and inform policy-makers aiming to bridge literacy gaps. Determining how to best adapt information to patients’ literacy level and thereby assist them in managing their own health is a significant clinical outcome. A substantial methodological consequence is the inevitability of Rasch modelling in measurement. We also found that Wright’s method identified rating scale cut-off scores consistently across independent samples. To unveil sources of potential biases, threats to validity and imprecision of benchmarks, replicating our study in other contexts is required.

Towards a progression of health literacy skills: Establishing the HLS-Q12 cutoff scores

2019 ◽  
Author(s):  
Øystein Guttersrud ◽  
Christopher Le ◽  
Kjell Sverre Pettersen ◽  
Sølvi Helseth ◽  
Hanne Søberg Finbråten
Keyword(s):  
Health Literacy ◽  
Rating Scale ◽  
Short Form ◽  
Population Sample ◽  
Measurement Model ◽  
Literacy Skills ◽  
Item Calibration ◽  
Rasch Modelling ◽  
Cutoff Scores ◽  
Item Content

Abstract Background The self-reported European Health Literacy Survey Questionnaire (HLS-EU-Q47) is a widely used measure for population health literacy. Based on confirmatory factor analyses and Rasch modelling, the short form HLS-Q12 was developed to meet the Rasch unidimensional measurement model expectations. After its publication, there was a worldwide call to identify HLS-Q12 cutoff scores and establish clearly delineated standards regarding the skills assessed. This study therefore aims to identify the HLS-Q12 scores associated with statistically distinct levels of proficiency and to construct a proficiency scale that may indicate what individuals typically know and can do at increasingly sophisticated levels of health literacy. Methods We applied the unidimensional Rasch measurement model for polytomous items to responses from 900 randomly sampled individuals and 388 individuals with type 2 diabetes. Using Rasch based item calibration, we constructed a proficiency scale by locating the ordered item thresholds along the scale. By applying Wright’s method for the maximum number of strata, we determined the cutoff scores for significantly different levels. By directly referring to item content that people who achieved the cutoff scores viewed as ‘easy’, we suggested what these gradually more advanced levels of health literacy might mean in terms of item content. Results Analysing the population sample, we identified statistically distinct levels of health literacy at the empirically identified cutoff scores 27, 33 and 39. We confirmed them by analysing the responses from individuals with diabetes. Using item calibration, the resulting HLS-Q12 proficiency scale expresses typical knowledge and skills at these three statistically distinct levels. The scale’s cumulative nature indicates what it may mean qualitatively to move from low to high health literacy. Conclusions By identifying levels of health literacy, we may initiate the improvement of current models of health literacy. Determining how to adapt information to patients’ health literacy level is a possible clinical outcome. A substantial methodological outcome is the inevitability of Rasch modelling in measurement. We found that Wright’s method identified rating scale cutoff scores consistently across independent samples. To reveal sources of potential biases, threats to validity and imprecision of benchmarks, replication of our study in other contexts is required

Actual and perceived patient health literacy: How accurate are residents’ predictions?

2019 ◽  
Vol 54 (4-5) ◽  
pp. 290-295 ◽  
Author(s):  
Laci L Zawilinski ◽  
Heather Kirkpatrick ◽  
Barbara Pawlaczyk ◽  
Himabindu Yarlagadda
Keyword(s):  
Health Literacy ◽  
Health Outcomes ◽  
Short Form ◽  
Literacy Skills ◽  
Assessment Tools ◽  
Future Directions ◽  
Resident Physicians ◽  
Patient Health ◽  
Study Participants ◽  
Negative Health Outcomes

Health literacy has repeatedly been shown to be associated with a multitude of negative health outcomes. Previous research has shown that patient health literacy levels are hard to predict by physicians and that assessment tools used to measure health literacy may be outdated or lacking. The purpose of this study is to replicate and extend the findings of previous research by examining residents’ ability to predict health literacy levels in patients and to use a newer validated measure of health literacy. A total of 38 patient encounters were included in this study. Patients were administered the Health Literacy Skills Instrument-Short Form to assess health literacy levels. Twenty resident physicians conducted visits with study participants and were asked to predict the health literacy of their patients. Results indicated that, consistent with previous research, residents’ predictions of patient health literacy were not consistent with patient health literacy levels as measured by the Health Literacy Skills Instrument-Short Form. Implications of these findings and future directions are discussed.

scholarly journals Utility of medicines information leaflets in hypertensive care in a setting with low health literacy: A cross-sectional study

2020 ◽  
Vol 4 ◽  
pp. 239920262091003
Author(s):  
Mtungwazi Kudzinesta ◽  
Mwangana Mubita ◽  
Francis Kalemeera ◽  
Brian Godman ◽  
Ester Hango ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Health Literacy ◽  
Health Information ◽  
Short Form ◽  
Literacy Skills ◽  
Public Health Care ◽  
Hypertensive Patients ◽  
Information Leaflets ◽  
Medicines Information ◽  
Low Health Literacy

Introduction: Higher levels of health literacy improve utilization of health information, medication adherence and outcomes. Few studies evaluate the utility of medicines information in hypertensive care in settings with low health literacy. Aim: To determine the level of health literacy and utility of medicines information leaflets (MILs) among hypertensive patients in public health care in Namibia. Methods: A hospital-based survey among hypertensive patients receiving care at a referral hospital in Namibia from the 8 June 2018 to 29 June 2018. Patient’s health literacy and utility of MIL were assessed using three literacy tools and a survey questionnaire. Quantitative data were analysed using descriptive statistics and qualitative thematic content analysis for factors associate with the utility of the MIL. Results: Of the 139 patients, 63% were female and the mean age was 45.7 (range: 19.0–84.0) years. Over 85.6% had of low literacy skills (Rapid Estimate of Literacy in Medicine (REALM) score <44, that is, unable to read simple health materials), 38.8% had positive Single Item Literacy Screener (SILS) scores (⩾2, require help to read medicines information) and 66.9% had inadequate skills for comprehension, appraisal and decision-making with regard to health information (Health Literacy Skills Instrument-Short Form (HLSI-SF) score <70%). The level of access to and utility of MIL were low, 32.4% and 34.6%, respectively. The main factors associated with poor utility of the MIL were low patient health literacy, lack of guidelines on the use of MIL and MIL written in non-native languages. Conclusion: Low rates of health literacy and utility of MIL were observed among hypertensive patients in Namibia. The integration of health literacy programmes, and MIL guidelines are needed to promote utility of medicine information and improve medication adherence.

The Health Literacy Skills Instrument: A 10-Item Short Form

2012 ◽  
Vol 17 (sup3) ◽  
pp. 191-202 ◽  
Author(s):  
Carla M. Bann ◽  
Lauren A. McCormack ◽  
Nancy D. Berkman ◽  
Linda B. Squiers
Keyword(s):  
Health Literacy ◽  
Short Form ◽  
Literacy Skills

scholarly journals Structural, Age, and Sex Differences for a Short Form of the Inventory of Parent and Peer Attachment: The IPPA-45

2014 ◽  
Vol 5 ◽  
Author(s):  
Ross B. Wilkinson ◽  
Daphne Yun Lin Goh
Keyword(s):  
Sex Differences ◽  
Short Form ◽  
Measurement Model ◽  
Peer Attachment ◽  
Self Report ◽  
Confirmatory Factor Analyses ◽  
Attachment Relationships ◽  
Measurement Models ◽  
English Speaking ◽  
Age Range

The Inventory of Parent and Peer Attachment (IPPA) is the most widely used self-report measure of adolescent attachment relationships. This study reports the development of the IPPA-45, a short-form of the IPPA that assesses the quality of mother, father, and peer attachment relationships. A hierarchical measurement model is proposed with three lower-order factors and a higher-order factor. Confirmatory factor analyses were conducted using a sample of 1,025 English-speaking adolescents (387 males) aged 13 to 18 years. Results support the hierarchical factor structure, and tests of model invariance demonstrated that the measurement models were similar regardless of age or sex. Differences in mean scores were found with regard to attachment target, gender and age. Overall, the IPPA-45 is supported as a psychometrically sound measure of relationship attachment across the age-range of adolescence.

scholarly journals Validating the Functional, Communicative, and Critical Health Literacy Scale Using Rasch Modeling and Confirmatory Factor Analysis

2018 ◽  
Vol 26 (2) ◽  
pp. 341-363 ◽  
Author(s):  
Hanne Søberg Finbråten ◽  
Øystein Guttersrud ◽  
Gun Nordström ◽  
Kjell Sverre Pettersen ◽  
Anne Trollvik ◽  
...  
Keyword(s):  
Health Literacy ◽  
Rasch Model ◽  
Rating Scale ◽  
Three Dimensional ◽  
Rasch Modeling ◽  
Confirmatory Factor Analyses ◽  
Critical Health Literacy ◽  
Point Rating Scale ◽  
Confirmatory Factor

Background and Purpose:The functional, communicative, and critical health literacy (FCCHL) scale is widely used for assessing health literacy (HL) in people with chronic diseases, such as type 2 diabetes (T2DM). Despite related subscales, researchers continue to apply a consecutive modeling approach, treating the three subscales as independent. This article studies the psychometric characteristics of the FCCHL by applying multidimensional modeling approaches.Methods:Rasch modeling and confirmatory factor analyses were applied to responses (paper-and-pencil) from 386 adults with T2DM.Results:Using a six-point rating scale and a three-dimensional Rasch model, this study found that a 12-item version of the FCCHL reduced within-item bias and improved subscale reliability indexes.Conclusion:This study suggests a parsimonious 12-item version of the FCCHL. The data fit a three-dimensional Rasch model best.

Health Literacy Skills Instrument--Short Form

2012 ◽  
Author(s):  
Carla M. Bann ◽  
Lauren A. McCormack ◽  
Nancy D. Berkman ◽  
Linda B. Squiers
Keyword(s):  
Health Literacy ◽  
Short Form ◽  
Literacy Skills

scholarly journals Health literacy and digital media use: Assessing the Health Literacy Skills Instrument – Short Form and its correlates among African American college students

2018 ◽  
Vol 4 ◽  
pp. 205520761877076 ◽  
Author(s):  
Judith E. Rosenbaum ◽  
Benjamin K. Johnson ◽  
Amber E. Deane
Keyword(s):  
College Students ◽  
African American ◽  
Health Literacy ◽  
Digital Media ◽  
Media Use ◽  
Short Form ◽  
Literacy Skills ◽  
African American College Students ◽  
Health Related ◽  
The Media

Improving health literacy is increasingly seen as a solution to health problems and inequalities. This study assesses how one of the more recent measures of health literacy, the Health Literacy Skills Instrument – Short Form, performs among African American college students, and ascertains if and how media use relates to health literacy. Results indicate that both the use of health-related websites and apps as well as overall time spent with the media were positively, but conditionally, linked to health literacy. However, findings also pointed to the need for further test development.

Measuring Attachment Dimensions in Adolescents: Development and Validation of the Experiences in Close Relationships — Revised — General Short Form

2011 ◽  
Vol 2 (1) ◽  
pp. 53-62 ◽  
Author(s):  
Ross B. Wilkinson
Keyword(s):  
Close Relationships ◽  
Discriminant Validity ◽  
Factor Model ◽  
Short Form ◽  
Measurement Model ◽  
Attachment Anxiety ◽  
Confirmatory Factor Analyses ◽  
Experiences In Close Relationships ◽  
Relationship Attachment ◽  
Attachment Dimensions

AbstractThe assessment of attachment in adolescence remains problematic, with the most widely used measure, the Inventory of Parent and Peer Attachment (IPPA; Armsden & Greenberg, 1987), argued to have major short-comings. This article reports two studies examining the psychometric properties of a shortened and modified version of the Experiences in Close Relationships — Revised (ECR-R) (Fraley, Waller, & Brennan, 2000), the Experiences in Close Relationships — Revised — General Short Form (ECR-R-GSF), for the assessment of general relationship attachment anxiety and avoidance in adolescents and young adults. Confirmatory factor analyses in two independent samples of high school and university students (TotalN= 1187, 11 to 22 years) demonstrate support for the two-factor model of attachment anxiety and avoidance. The measurement model was supported across data sets and was not significantly different with respect to either age or sex. While the ECR-R-GSF demonstrated appropriate convergent and discriminant validity with the Relationships Questionnaire (RQ (Bartholomew & Horowitz, 1991) it did not converge with specific, parental relationship attachment as assessed by the IPPA. The ECR-R-GSF is argued to be a reliable and psychometrically sound instrument for assessing general attachment dimensions across a wide age range.

Identification and Utility of a Short Form of the Pediatric Symptom Checklist-Youth Self-Report (PSC-17-Y)

2020 ◽  
Vol 36 (1) ◽  
pp. 56-64
Author(s):  
Paul Bergmann ◽  
Cara Lucke ◽  
Theresa Nguyen ◽  
Michael Jellinek ◽  
John Michael Murphy
Keyword(s):  
Psychosocial Functioning ◽  
Short Form ◽  
Parent Report ◽  
Self Report ◽  
Symptom Checklist ◽  
Factor Analyses ◽  
Youth Self Report ◽  
Confirmatory Factor Analyses ◽  
Pediatric Symptom Checklist ◽  
Exploratory Factor Analyses

Abstract. The Pediatric Symptom Checklist-Youth self-report (PSC-Y) is a 35-item measure of adolescent psychosocial functioning that uses the same items as the original parent report version of the PSC. Since a briefer (17-item) version of the parent PSC has been validated, this paper explored whether a subset of items could be used to create a brief form of the PSC-Y. Data were collected on more than 19,000 youth who completed the PSC-Y online as a self-screen offered by Mental Health America. Exploratory factor analyses (EFAs) were first conducted to identify and evaluate candidate solutions and their factor structures. Confirmatory factor analyses (CFAs) were then conducted to determine how well the data fit the candidate models. Tests of measurement invariance across gender were conducted on the selected solution. The EFAs and CFAs suggested that a three-factor short form with 17 items is a viable and most parsimonious solution and met criteria for scalar invariance across gender. Since the 17 items used on the parent PSC short form were close to the best fit found for any subsets of items on the PSC-Y, the same items used on the parent PSC-17 are recommended for the PSC-Y short form.

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