Xiangya School of Nursing, Central South University, Changsha, Hunan, People's Republic of China.
BMC Public Health. 2019 Sep 4;19(1):1220. doi: 10.1186/s12889-019-7563-x.
Health literacy is defined as the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand and use information in ways that promote and maintain good health. A Health Literacy Questionnaire (HLQ) is a toolkit with good reliability and validity. Accordingly, this study administered HLQ among older adults in China to examine its factor structure, reliability, homogeneity, and discriminant validity for use in understanding better the health literacy of older adults and determining corresponding measures.
Psychometric properties were examined based on the data collected via face-to-face interviews (N = 343). Tests included the difficulty level, composite scale reliability, confirmatory factor analysis (CFA), and Bayesian structural equation modeling (BSEM).
The easiest scale to obtain a high score was "Social support for health" and the hardest, "Navigating the health care system" and "Appraisal of health information." Two one-factor models fitted well with no correlated residuals allowed. After model modification, the CFA fit statistics of the other seven scales were good. All HLQ scales were found to be homogenous, with a composite reliability ranging from 0.74 to 0.85. The nine-factor Bayesian structural equation model fitted the data well (Posterior-Predictive-P value = 0.670; 95% Confidence Interval for the difference between the observed and replicated Chi-square values = - 163.320, 102.750).
The Chinese version of the HLQ has strong construct and content validity and high composite reliability when applied to older adults in Changsha City, China. Therefore, the nine-scale HLQ can now be administered to Chinese older adults, thereby providing a powerful approach to understanding the multidimensional area of health literacy.
健康素养被定义为个体获取、理解和使用信息以促进和维持健康的动机和能力的认知和社会技能。健康素养问卷（HLQ）是一个具有良好信度和效度的工具包。因此，本研究在中国老年人中使用 HLQ 进行调查，以检验其结构因素、信度、同质性和判别效度，以便更好地了解老年人的健康素养，并确定相应的措施。
根据面对面访谈收集的数据（N=343），对心理测量学特性进行了检验。测试包括难度水平、综合量表信度、验证性因子分析（CFA）和贝叶斯结构方程建模（BSEM）。
最容易获得高分的量表是“健康的社会支持”，最难的是“导航医疗保健系统”和“评估健康信息”。允许没有相关残差的两种单因素模型拟合良好。经过模型修正，其他七个量表的 CFA 拟合统计数据良好。所有 HLQ 量表都具有同质性，综合可靠性在 0.74 至 0.85 之间。九因素贝叶斯结构方程模型很好地拟合了数据（后验预测 P 值=0.670；观察值和复制卡方值之间差异的 95%置信区间=-163.320，102.750）。
中文版 HLQ 在中国长沙市老年人中具有较强的结构和内容效度以及较高的综合可靠性。因此，现在可以对中国老年人进行九分量表 HLQ 测试，从而为理解健康素养的多维领域提供有力的方法。
