Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
Hong Kong Med J. 2020 Oct;26(5):404-412. doi: 10.12809/hkmj208395. Epub 2020 Sep 25.
This study aimed to develop and validate a brief practitioner-friendly health literacy screening tool, called Rapid Estimate of Inadequate Health Literacy (REIHL), that estimates patients' health literacy inadequacy in demanding clinical settings.
This is a methodological study of 304 community-dwelling older adults recruited from one community health centre and five district elderly community centres. Logistic regression models were used to identify the coefficients of the REIHL score's significant factors. Receiver operating characteristic (ROC) curve analysis was then used to assess the REIHL's sensitivity and specificity. Path analysis was employed to examine the REIHL's criterion validity with the Chinese Health Literacy Scale for Chronic Care and concurrent validity with self-rated health scale and the Geriatric Depression Scale-15.
The REIHL has scores ranging from 0 to 23. It had 76.9% agreement with the Chinese Health Literacy Scale for Chronic Care. The area under the ROC curve for predicting health literacy inadequacy was 0.82 (95% confidence interval=0.78-0.87, P<0.001). The ROC curve of the REIHL showed that scores ≥11 had a sensitivity of 77.8% and specificity of 75.6% for predicting health literacy inadequacy. The path analysis model showed excellent fit (Chi squared [2, 304] 0.16, P=0.92, comparative fit index 1.00, root mean square error of approximation <0.001, 90% confidence interval=0.00-0.04), indicating that the REIHL has good criterion and concurrent validity.
The newly developed REIHL is a practical tool for estimating older adults' inadequate health literacy in clinical care settings.
本研究旨在开发和验证一种简洁的、适合从业者使用的健康素养筛查工具，称为快速估计健康素养不足（REIHL），用于评估患者在高要求临床环境中健康素养不足的情况。
这是一项针对 304 名社区居住的老年人的方法学研究，他们来自一家社区健康中心和五家地区老年社区中心。逻辑回归模型用于确定 REIHL 评分显著因素的系数。然后，使用接收者操作特征（ROC）曲线分析评估 REIHL 的灵敏度和特异性。路径分析用于检验 REIHL 与慢性病中文健康素养量表的效标效度和与自感健康量表和老年抑郁量表-15 的同时效度。
REIHL 的分数范围为 0 到 23。它与慢性病中文健康素养量表的一致性为 76.9%。预测健康素养不足的 ROC 曲线下面积为 0.82（95%置信区间为 0.78-0.87，P<0.001）。REIHL 的 ROC 曲线显示，得分≥11 预测健康素养不足的灵敏度为 77.8%，特异性为 75.6%。路径分析模型显示出良好的拟合度（卡方[2,304]0.16，P=0.92，比较拟合指数 1.00，近似均方误差<0.001，90%置信区间为 0.00-0.04），表明 REIHL 具有良好的效标和同时效度。
新开发的 REIHL 是一种在临床护理环境中评估老年人健康素养不足的实用工具。
