The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ).
The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ).
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DOI：
10.1186/1471-2458-13-658
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发表时间：
2013-07-16
影响因子：
4.5
通讯作者：
Buchbinder R
中科院分区：
文献类型：
--
作者：
Osborne RH;Batterham RW;Elsworth GR;Hawkins M;Buchbinder R
健康素养已成为公共卫生领域一个日益重要的概念。我们试图通过利用普通人群，患者，从业人员和政策制定者的观点，制定一个能够诊断个人和组织健康素养需求的健康素养综合衡量标准。使用有效性驱动的方法，我们进行了接地协商（研讨会和访谈），以确定广泛的概念上不同的领域。问卷项目是直接从咨询数据中开发的，遵循严格的程序，旨在获取目前从事医疗保健的人员到普通人群的全方位经验。心理测量学分析包括验证性因素分析和项目反应理论。认知访谈被用来确保问题被理解为预期的。项目最初在社区卫生，家庭护理和医院设置的校准样本（N=634），然后在一个复制样本（N=405），包括最近的急诊科就诊者进行了测试。最初，在6个具有同意/不同意响应选项的量表和5个具有难以执行任务响应选项的量表中生成了91个项目。认知测试显示，大多数项目都很好地理解，只有一些轻微的措辞是必要的。校准样本的心理测试确定了34个表现不佳或概念上冗余的项目，并将其删除，得到10个量表。然后在重复样本中进行测试，并进行改进，以产生包括44个项目的9个最终量表。一个9因素的CFA模型拟合这些项目，没有交叉负荷或相关残差允许。考虑到模型的非常有限的性质，拟合相当令人满意：χ 2 WLSMV（866 d.f.）= 2927，p<0.000，CFI = 0.936，TLI = 0.930，RMSEA = 0.076和WRMR = 1.698。最终量表包括：感觉得到医疗保健提供者的理解和支持;有足够的信息来管理我的健康;积极管理我的健康;健康的社会支持;健康信息的评估;能够积极与医疗保健提供者互动;导航医疗保健系统;能够找到良好的健康信息;以及足够了解健康信息，知道该怎么做。HLQ涵盖了9个概念上不同的健康素养领域，以评估广泛人群和组织的需求和挑战。由于有效性驱动的方法，HLQ可能是有用的调查，干预评估，个人的需求和能力的研究。
Health literacy has become an increasingly important concept in public health. We sought to develop a comprehensive measure of health literacy capable of diagnosing health literacy needs across individuals and organisations by utilizing perspectives from the general population, patients, practitioners and policymakers. Using a validity-driven approach we undertook grounded consultations (workshops and interviews) to identify broad conceptually distinct domains. Questionnaire items were developed directly from the consultation data following a strict process aiming to capture the full range of experiences of people currently engaged in healthcare through to people in the general population. Psychometric analyses included confirmatory factor analysis (CFA) and item response theory. Cognitive interviews were used to ensure questions were understood as intended. Items were initially tested in a calibration sample from community health, home care and hospital settings (N=634) and then in a replication sample (N=405) comprising recent emergency department attendees. Initially 91 items were generated across 6 scales with agree/disagree response options and 5 scales with difficulty in undertaking tasks response options. Cognitive testing revealed that most items were well understood and only some minor re-wording was required. Psychometric testing of the calibration sample identified 34 poorly performing or conceptually redundant items and they were removed resulting in 10 scales. These were then tested in a replication sample and refined to yield 9 final scales comprising 44 items. A 9-factor CFA model was fitted to these items with no cross-loadings or correlated residuals allowed. Given the very restricted nature of the model, the fit was quite satisfactory: χ2WLSMV(866 d.f.) = 2927, p<0.000, CFI = 0.936, TLI = 0.930, RMSEA = 0.076, and WRMR = 1.698. Final scales included: Feeling understood and supported by healthcare providers; Having sufficient information to manage my health; Actively managing my health; Social support for health; Appraisal of health information; Ability to actively engage with healthcare providers; Navigating the healthcare system; Ability to find good health information; and Understand health information well enough to know what to do. The HLQ covers 9 conceptually distinct areas of health literacy to assess the needs and challenges of a wide range of people and organisations. Given the validity-driven approach, the HLQ is likely to be useful in surveys, intervention evaluation, and studies of the needs and capabilities of individuals.
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影响因子：
2
作者：
Krau, Stephen D.
通讯作者：
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影响因子：
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