Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
Health Promot Int. 2012 Mar;27(1):45-51. doi: 10.1093/heapro/dar020. Epub 2011 Apr 5.
Due to the concern of equating correct pronunciation with comprehension and the differences in health care systems, existing health literacy (HL) instruments may not be appropriate for or applicable to English-speaking countries other than the USA. The purpose of this study was to develop and validate the Health Literacy Test for Singapore (HLTS), which is an adapted version of the Short-Test of Functional Health Literacy in Adults. Three hundred and two patients were interviewed and administered the HLTS, the Newest Vital Sign (NVS), a demographic questionnaire, and a knowledge test of chronic diseases. The convergent validity of HLTS was determined by examining the association between HLTS and NVS HL levels, whereas predictive validity was tested by examining the difference in knowledge of chronic conditions between the two HLTS HL (i.e. adequate and inadequate HL) groups. Bivariate correlation of HLTS HL levels with age and education was assessed to test a priori hypotheses that patients with inadequate HL were older and less educated. The results showed that HLTS displayed good internal reliability (Cronbach's alpha = 0.87). The correlation between HLTS and NVS was moderate (γ = 0.55; P = 0.005) and individuals with inadequate HL were older (P = 0.002) and less educated (P = 0.007). In addition, patients with adequate HL had a higher mean score on the chronic disease knowledge test (P = 0.036). In conclusion, the HLTS is a valid and reliable measure for assessing Singaporeans ability to read and comprehend health-related materials written in English.
由于担心将正确发音等同于理解能力，以及医疗保健系统的差异，现有的健康素养（HL）工具可能不适合或不适用于美国以外的英语国家。本研究旨在开发和验证新加坡健康素养测试（HLTS），这是成人功能性健康素养简短测试的改编版。302 名患者接受了 HLTS、最新生命体征（NVS）、人口统计学问卷和慢性病知识测试的访谈和管理。HLTS 的收敛有效性通过检查 HLTS 与 NVS HL 水平之间的关联来确定，而预测有效性则通过检查 HLTS 两个 HL（即足够和不足 HL）组之间慢性病知识的差异来测试。评估 HLTS HL 水平与年龄和教育程度的双变量相关性，以检验假设，即不足 HL 的患者年龄较大且受教育程度较低。结果表明，HLTS 具有良好的内部可靠性（Cronbach's alpha = 0.87）。HLTS 与 NVS 的相关性适中（γ = 0.55；P = 0.005），不足 HL 的个体年龄较大（P = 0.002）且受教育程度较低（P = 0.007）。此外，具有足够 HL 的患者在慢性病知识测试中的平均得分更高（P = 0.036）。总之，HLTS 是一种有效且可靠的工具，可用于评估新加坡人阅读和理解英文健康相关材料的能力。
