Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Korea.
Epidemiol Health. 2024;46:e2024061. doi: 10.4178/epih.e2024061. Epub 2024 Jul 10.
We developed and validated the Health Literacy Index for the Community (HLIC) to assess the health literacy of the Korean population within the framework of the Korean National Health and Nutrition and Examination Survey.
The HLIC was developed through (1) defining the conceptual framework and generating the item pool and (2) finalizing the items and identifying the cut-off value. Interviews were conducted to examine items' face validity, and a cross-sectional survey was performed to analyze the item-response theory and Rasch models to investigate the instrument's psychometric properties.
In this study of 1,041 participants, most had no difficulty understanding health information; however, 67.9% struggled to assess the reliability of health information from the Internet or media. A 4-factor structure was identified through factor analysis, leading to the exclusion of some items. This resulted in 10 items across 4 domains: (1) disease prevention, (2) health promotion, (3) health care, and (4) technology and resources. The HLIC demonstrated good internal consistency, with a Cronbach's α of 0.87. It also showed high test-retest reliability and correlations with other health literacy instruments. A socio-demographic analysis of the HLIC revealed disparities in health literacy across various age groups, education levels, and income brackets.
The HLIC was developed to systematically measure health literacy in Korea's general population. Its simplicity and conciseness ensure reliability and validity and improve its accessibility, making it particularly suitable for the broader Korean population, including those with lower literacy levels.
我们开发并验证了社区健康素养指数（HLIC），以在韩国国民健康与营养调查的框架内评估韩国人口的健康素养。
HLIC 通过以下步骤进行开发：（1）定义概念框架并生成项目池；（2）最终确定项目并确定临界值。对项目进行访谈以检验其表面效度，同时进行横断面调查以分析项目反应理论和 Rasch 模型，以调查该工具的心理测量特性。
在这项对 1041 名参与者的研究中，大多数人理解健康信息没有困难；然而，67.9%的人难以评估来自互联网或媒体的健康信息的可靠性。通过因子分析确定了一个 4 因素结构，导致一些项目被排除在外。这导致了 4 个领域的 10 个项目：（1）疾病预防；（2）健康促进；（3）医疗保健；和（4）技术和资源。HLIC 表现出良好的内部一致性，克朗巴赫的α为 0.87。它还表现出较高的重测信度和与其他健康素养工具的相关性。对 HLIC 的社会人口统计学分析表明，健康素养在不同年龄组、教育水平和收入阶层之间存在差异。
HLIC 的开发是为了系统地衡量韩国一般人群的健康素养。它的简单性和简洁性确保了可靠性和有效性，并提高了其可及性，使其特别适合更广泛的韩国人群，包括那些文化程度较低的人群。
