西班牙医学数字理解工具的开发与验证
Development and Validation of the Spanish Numeracy Understanding in Medicine Instrument.
作者信息
Jacobs Elizabeth A, Walker Cindy M, Miller Tamara, Fletcher Kathlyn E, Ganschow Pamela S, Imbert Diana, O'Connell Maria, Neuner Joan M, Schapira Marilyn M
机构信息
Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, 53705, USA.
Department of Educational Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
出版信息
J Gen Intern Med. 2016 Nov;31(11):1345-1352. doi: 10.1007/s11606-016-3759-2. Epub 2016 Jun 16.
BACKGROUND
The Spanish-speaking population in the U.S. is large and growing and is known to have lower health literacy than the English-speaking population. Less is known about the health numeracy of this population due to a lack of health numeracy measures in Spanish.
OBJECTIVE
we aimed to develop and validate a short and easy to use measure of health numeracy for Spanish-speaking adults: the Spanish Numeracy Understanding in Medicine Instrument (Spanish-NUMi).
DESIGN
Items were generated based on qualitative studies in English- and Spanish-speaking adults and translated into Spanish using a group translation and consensus process. Candidate items for the Spanish NUMi were selected from an eight-item validated English Short NUMi. Differential Item Functioning (DIF) was conducted to evaluate equivalence between English and Spanish items. Cronbach's alpha was computed as a measure of reliability and a Pearson's correlation was used to evaluate the association between test scores and the Spanish Test of Functional Health Literacy (S-TOFHLA) and education level.
PARTICIPANTS
Two-hundred and thirty-two Spanish-speaking Chicago residents were included in the study.
KEY RESULTS
The study population was diverse in age, gender, and level of education and 70 % reported Mexico as their country of origin. Two items of the English eight-item Short NUMi demonstrated DIF and were dropped. The resulting six-item test had a Cronbach's alpha of 0.72, a range of difficulty using classical test statistics (percent correct: 0.48 to 0.86), and adequate discrimination (item-total score correlation: 0.34-0.49). Scores were positively correlated with print literacy as measured by the S- TOFHLA (r = 0.67; p < 0.001) and varied as predicted across grade level; mean scores for up to eighth grade, ninth through twelfth grade, and some college experience or more, respectively, were 2.48 (SD ± 1.64), 4.15 (SD ± 1.45), and 4.82 (SD ± 0.37).
CONCLUSIONS
The Spanish NUMi is a reliable and valid measure of important numerical concepts used in communicating health information.
背景
美国讲西班牙语的人口众多且不断增长，已知其健康素养低于讲英语的人口。由于缺乏西班牙语的健康数字能力测评工具，对于这一人群的健康数字能力了解较少。
目的
我们旨在开发并验证一种针对讲西班牙语成年人的简短且易于使用的健康数字能力测评工具：西班牙语医学数字理解工具（Spanish-NUMi）。
设计
基于对讲英语和讲西班牙语成年人的定性研究生成条目，并通过小组翻译和共识过程将其翻译成西班牙语。西班牙语NUMi的候选条目从经过验证的八项英语简短NUMi中选取。进行差异项目功能（DIF）评估以检验英语和西班牙语条目的等效性。计算克朗巴哈系数（Cronbach's alpha）作为可靠性指标，并使用皮尔逊相关系数评估测试分数与西班牙语功能性健康素养测试（S-TOFHLA）及教育水平之间的关联。
参与者
232名讲西班牙语的芝加哥居民纳入本研究。
主要结果
研究人群在年龄﹑性别和教育水平方面具有多样性，70%的人报告其原籍国为墨西哥。八项英语简短NUMi中的两项显示存在DIF并被剔除。最终的六项测试克朗巴哈系数为0.72，使用经典测试统计方法得出的难度范围（正确率：0.48至0.86），以及足够的区分度（项目总分相关性：0.34 - 0.49）。分数与S-TOFHLA测量的印刷素养呈正相关（r = 0.67；p < 0.001），并且如预期那样随年级水平变化；八年级及以下、九年级至十二年级、有一些大学经历或更多经历的平均分数分别为2.48（标准差±1.64）、4.15（标准差±1.45）和4.82（标准差±0.37）。
结论
西班牙语NUMi是用于传达健康信息的重要数字概念的可靠且有效的测评工具。
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