Yadate Tolasa, Girma Eshetu, Tadesse Yordanos, Dejene Tariku, Abebe Finina
School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia.
School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Arch Public Health. 2024 Aug 8;82(1):120. doi: 10.1186/s13690-024-01343-z.
Since health literacy is known to be related to health outcomes, it should be measured to explain how it is associated with the health status of the population. Health literacy tools are designed to measure different dimensions of health literacy of individuals based on their objective. The AAHLS tool is comprehensive and can cover all aspects of health literacy. Overall in Ethiopia, there is no standard health literacy tool that has been developed or/and validated. Therefore, the aim of this study was to adapt and validate the All Aspects of Health Literacy Scale (AAHLS) in healthcare facilities in Addis Ababa city, Ethiopia.
A mixed-method, facility-based, cross-sectional study was conducted in Addis Ababa city from February 1, 2022, to May 30, 2022. The study was conducted in three phases: forward and backward translation and expert review, cognitive interviews and survey administration. For the cognitive interviews, a total of 16 participants and for the survey administration, 199 participants were involved. Coding and analysis of the qualitative data were performed using OpenCode 4.03 computer software. Then, pretesting (survey administration) was conducted to check the validity and reliability of the tool. CFA was conducted using SPSS version 26 and Stata version 14.
The original three response categories were revised to five response categories based on the cognitive interview findings and expert reviews. The survey was administered to 199 participants, 55.8% of whom were males. The Kaiser‒Meyer‒Olkin measure of sampling adequacy was 0.685, with a significant difference according to Bartlett's test of sphericity (p < 0.001). After removing the empowerment factor model fit indices, the internal reliability and convergent and divergent validities improved. Confirmatory factor analysis showed that the model fit indices of the tool were satisfactory. The overall internal consistency, Cronbach's alpha, was 0.71.
The three response categories of the tool were revised to five response categories. The AAHLS tool was revised to include 10 items. The tool has exhibited adequate model fitness. The validated tool can be used for future health literacy assessments and interventions.
由于健康素养与健康结果相关，因此应进行测量以解释其与人群健康状况的关联。健康素养工具旨在根据其目标测量个体健康素养的不同维度。AAHLS工具全面，能够涵盖健康素养的各个方面。总体而言，埃塞俄比亚尚未开发或验证过标准的健康素养工具。因此，本研究的目的是在埃塞俄比亚亚的斯亚贝巴市的医疗机构中对健康素养综合量表（AAHLS）进行改编和验证。
2022年2月1日至2022年5月30日在亚的斯亚贝巴市进行了一项基于机构的混合方法横断面研究。该研究分三个阶段进行：正向和反向翻译及专家评审、认知访谈和问卷调查。认知访谈共纳入16名参与者，问卷调查共纳入199名参与者。使用OpenCode 4.03计算机软件对定性数据进行编码和分析。然后，进行预测试（问卷调查）以检验该工具的有效性和可靠性。使用SPSS 26版和Stata 14版进行验证性因子分析。
根据认知访谈结果和专家评审，将原来的三个回答类别修订为五个回答类别。对199名参与者进行了问卷调查，其中55.8%为男性。Kaiser-Meyer-Olkin抽样适当性度量为0.685，根据Bartlett球形检验有显著差异（p < 0.001）。去除赋权因子模型拟合指标后，内部信度以及收敛效度和区分效度均有所提高。验证性因子分析表明该工具的模型拟合指标令人满意。总体内部一致性，即Cronbach's alpha为0.71。
该工具的三个回答类别修订为五个回答类别。AAHLS工具修订后包括10个项目。该工具已表现出足够的模型适配性。经验证的工具可用于未来的健康素养评估和干预。
