Kolarcik Peter, Cepova Eva, Madarasova Geckova Andrea, Elsworth Gerald R, Batterham Roy W, Osborne Richard H
Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia.
Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 01, Kosice, Slovakia.
Int J Public Health. 2017 Jun;62(5):591-604. doi: 10.1007/s00038-017-0945-x. Epub 2017 Mar 3.
Health literacy is an important determinant of health and health equity and therefore requires robust measurement. The aim was to examine the psychometric properties of the Slovak version of the Health Literacy Questionnaire (HLQ) including revised wording of response categories.
A cross-sectional survey of the general Slovak adult population (N = 360, mean age 39) was conducted with the HLQ following its translation and cultural adaptation. Psychometric tests (confirmatory factor analysis, Cronbach's alpha, composite reliability) and association (linear regression, ANOVA) with sociodemographic variables were undertaken. The performance of alternative version of response options were explored with the Mann-Whittney U test and item response theory.
A highly restrictive nine-factor confirmatory factor analysis showed acceptable fit [χ WLSMV = 1684 (df = 866), p < 0.0001; CFI = 0.943, TLI = 0.938, RMSEA = 0.051, WRMR = 1.297] and reliability was acceptable (range 0.73-0.84). The revised response categories had a better distribution with lower average scores in three domains, compared with the original, and improved item information curves.
The nine HLQ scales are robust, providing a fine-grained assessment of health literacy. The revised response options improve psychometric properties and are recommended for future studies.
健康素养是健康和健康公平的重要决定因素，因此需要进行可靠的测量。本研究旨在检验斯洛伐克语版健康素养问卷（HLQ）的心理测量特性，包括对回答类别措辞的修订。
在HLQ完成翻译和文化调适后，对斯洛伐克成年人群体（N = 360，平均年龄39岁）进行了横断面调查。进行了心理测量测试（验证性因素分析、克朗巴哈系数、组合信度）以及与社会人口学变量的相关性分析（线性回归、方差分析）。采用曼-惠特尼U检验和项目反应理论对回答选项的替代版本的表现进行了探索。
一个高度受限的九因素验证性因素分析显示拟合度可接受[χWLSMV = 1684（自由度 = 8,66），p < 0.0001；CFI = 0.943，TLI = 0.938，RMSEA = 0.051，WRMR = 1.297]，信度也可接受（范围为0.73 - 0.84）。与原始版本相比，修订后的回答类别在三个领域的分布更好，平均得分更低，且项目信息曲线有所改善。
九个HLQ量表稳健，能对健康素养进行细致评估。修订后的回答选项改善了心理测量特性，建议在未来研究中使用。
