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Structural properties and psychometric improvements of the Health Literacy Questionnaire in a Slovak population

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

Health literacy is an important determinant of health and health equity and therefore requires robust measurement. The aim was to examine the psychometric properties of the Slovak version of the Health Literacy Questionnaire (HLQ) including revised wording of response categories.

Methods

A cross-sectional survey of the general Slovak adult population (N = 360, mean age 39) was conducted with the HLQ following its translation and cultural adaptation. Psychometric tests (confirmatory factor analysis, Cronbach’s alpha, composite reliability) and association (linear regression, ANOVA) with sociodemographic variables were undertaken. The performance of alternative version of response options were explored with the Mann–Whittney U test and item response theory.

Results

A highly restrictive nine-factor confirmatory factor analysis showed acceptable fit [χ 2WLSMV = 1684 (df  = 866), p < 0.0001; CFI = 0.943, TLI = 0.938, RMSEA = 0.051, WRMR = 1.297] and reliability was acceptable (range 0.73–0.84). The revised response categories had a better distribution with lower average scores in three domains, compared with the original, and improved item information curves.

Conclusions

The nine HLQ scales are robust, providing a fine-grained assessment of health literacy. The revised response options improve psychometric properties and are recommended for future studies.

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Acknowledgements

This work was partially funded by the Research and Development Support Agency (APVV-0032-11). Richard Osborne was funded in part through a National Health and Medical Research Council of Australia Senior Research Fellowship #APP1059122.

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Authors and Affiliations

  1. Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia

    Peter Kolarcik, Eva Cepova & Andrea Madarasova Geckova

  2. Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 01, Kosice, Slovakia

    Peter Kolarcik, Eva Cepova & Andrea Madarasova Geckova

  3. Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic

    Peter Kolarcik & Andrea Madarasova Geckova

  4. Health Systems Improvement Unit, School of Health and Social Development, Deakin University, Geelong, VIC, Australia

    Gerald R. Elsworth, Roy W. Batterham & Richard H. Osborne

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  1. Peter Kolarcik
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  2. Eva Cepova
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  3. Andrea Madarasova Geckova
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  4. Gerald R. Elsworth
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  5. Roy W. Batterham
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  6. Richard H. Osborne
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Correspondence to Peter Kolarcik.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kolarcik, P., Cepova, E., Madarasova Geckova, A. et al. Structural properties and psychometric improvements of the Health Literacy Questionnaire in a Slovak population. Int J Public Health 62, 591–604 (2017). https://doi.org/10.1007/s00038-017-0945-x

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  • DOI: https://doi.org/10.1007/s00038-017-0945-x

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