Haghdoost Ali Akbar, Rakhshani Fatemeh, Aarabi Mohsen, Montazeri Ali, Tavousi Mahmoud, Solimanian Atoosa, Sarbandi Fatemeh, Namdar Hosein, Iranpour Abedin
Research Center for Modeling in Health, Institute for Future Studies, Kerman University of Medical Sciences, Kerman, IR Iran.
School of Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Iran Red Crescent Med J. 2015 Jun 1;17(6):e25831. doi: 10.5812/ircmj.17(5)2015.25831. eCollection 2015 Jun.
Promoting Health Literacy (HL) is considered as an important goal in strategic plans of many countries. In spite of the necessity for access to valid, reliable and native HL instruments, the number of such instruments in the Persian language is scarce. Moreover, there is no good estimation of HL status in Iran.
The aim of this study was to provide a valid, reliable and native instrument to measure and monitor community HL in Iran and also, to provide an estimation of HL status in two Iranian provinces.
By applying the multistage cluster sampling, 1080 respondents (540 from each gender) were recruited from Kerman and Mazandaran provinces of Iran, from February to June 2014 to participate in this cross-sectional study. The development of the Iranian Health Literacy Questionnaire (IHLQ) was initiated with a comprehensive review of the literature. Then, face, content and construct validity as well as reliability were determined.
Internal consistency and test-retest reliability (ICC) of the factors was in the range of 0.71 to 0.96 and 0.73 to 0.86, respectively. In order to construct validity, Exploratory Factor Analysis (EFA) Kaiser-Meyer-Olkin (KMO) = 0.95 and Bartlett's test result of 3.017 with P < 0.001) with varimax rotation was used. Optimal reduced solution, including 36 items and seven factors, was found in EFA. Five of the factors identified were reading/comprehension skills, individual empowerment, communication/decision-making skills, social empowerment and health knowledge.
It was concluded that IHLQ might be a practical and useful tool for investigating HL for Persian language speakers around the world. Since HL is dynamic and its instruments should be regularly revised, further studies are recommended to assess HL with application of IHLQ to detect its potential imperfections.
提高健康素养（HL）被视为许多国家战略计划中的一个重要目标。尽管需要获得有效、可靠且本土化的HL工具，但波斯语的此类工具数量稀少。此外，伊朗缺乏对HL状况的良好评估。
本研究的目的是提供一种有效、可靠且本土化的工具，以测量和监测伊朗社区的HL，同时对伊朗两个省份的HL状况进行评估。
通过多阶段整群抽样，于2014年2月至6月从伊朗克尔曼省和马赞德兰省招募了1080名受访者（男女各540名），参与这项横断面研究。伊朗健康素养问卷（IHLQ）的开发始于对文献的全面综述。然后，确定了表面效度、内容效度、结构效度以及信度。
各因素的内部一致性和重测信度（ICC）分别在0.71至0.96和0.73至0.86的范围内。为了进行结构效度分析，使用了探索性因子分析（EFA），Kaiser-Meyer-Olkin（KMO）= 0.95，Bartlett检验结果为3.017（P < 0.001），采用方差最大化旋转。在EFA中发现了最优简化方案，包括36个项目和7个因子。确定的因子中有5个是阅读/理解技能、个人赋权、沟通/决策技能、社会赋权和健康知识。
得出的结论是，IHLQ可能是调查全球波斯语使用者HL的一种实用且有用的工具。由于HL是动态的，其工具应定期修订，建议进一步开展研究，应用IHLQ评估HL，以发现其潜在的不足之处。
