School of Public Health, Southern Medical University, No. 1023-1063, Satai South Road, Baiyun District, Guangzhou, 510000 Guangdong, China.
Nanfang Hospital, Southern Medical University, No. 1023-1063, Satai South Road, Baiyun District, Guangzhou, 510000 Guangdong, China.
Health Promot Int. 2024 Aug 1;39(4). doi: 10.1093/heapro/daae083.
The development of health literacy in China is relatively slow, and there are fewer health literacy scales, which is difficult to measure. Therefore, this study aims to promote the development of health literacy in China through the translation and application of the European Health Literacy Survey Questionnaire (HLS-EU-Q47). The scale was translated into Chinese, back-translated, culturally adapted and finally subjected to psychometric evaluation. A multi-stage stratified sampling method was used to select 2504 residents to test the reliability and validity of a questionnaire on health literacy. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the validity of the results, and the back consistency was calculated by Cronbach's alpha coefficient. The EFA revealed that health care, disease prevention and health promotion explained 78.68% of the total variance in health literacy. The scale and its subscales demonstrated strong internal consistency, with high Cronbach's alpha coefficients ranging from 0.947 to 0.983. CFA confirmed the three-factor model's goodness-of-fit for the Chinese population. The dimensions of healthcare, disease prevention and health promotion showed high convergent validity with an average variance extracted values ranging from 0.52 to 0.60 and composite reliability values ranging from 0.94 to 0.96. The reliable and valid Chinese version of the HLS-EU-Q47 (HLS19-Q47-CN) developed and evaluated in this study is an important tool for assessing health literacy levels in the Chinese population. Furthermore, as this tool has global applicability, it has the potential to assess health literacy levels across different countries, enabling practical international comparisons.
中国健康素养的发展相对缓慢，健康素养量表较少，难以衡量。因此，本研究旨在通过翻译和应用欧洲健康素养调查问卷（HLS-EU-Q47）来促进中国健康素养的发展。该量表被译为中文，然后回译、文化适应，最后进行心理测量评估。采用多阶段分层抽样方法，选择 2504 名居民对健康素养问卷的信度和效度进行测试。采用探索性因子分析（EFA）和验证性因子分析（CFA）评估结果的有效性，并通过 Cronbach's alpha 系数计算反向一致性。EFA 表明，医疗保健、疾病预防和健康促进解释了健康素养总方差的 78.68%。该量表及其分量表表现出较强的内部一致性，Cronbach's alpha 系数范围为 0.947 至 0.983。CFA 证实了三因素模型对中国人群的拟合优度。医疗保健、疾病预防和健康促进三个维度与平均方差提取值范围为 0.52 至 0.60 和综合可靠性值范围为 0.94 至 0.96 具有高度的收敛有效性。本研究开发和评估的 HLS-EU-Q47（HLS19-Q47-CN）中文可靠有效的版本是评估中国人群健康素养水平的重要工具。此外，由于该工具具有全球适用性，因此有可能评估不同国家的健康素养水平，从而实现实际的国际比较。
