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The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument

Health literacy is an asset for and indicator of adolescents’ health and wellbeing, and should therefore be monitored and addressed across countries. This study aimed to develop and validate a shorter version of the original 10-item health literacy for school-aged children instrument in a cross-nati...

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Autores principales: Paakkari, Olli, Kulmala, Markus, Lyyra, Nelli, Torppa, Minna, Mazur, Joanna, Boberova, Zuzana, Paakkari, Leena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618493/
https://www.ncbi.nlm.nih.gov/pubmed/37907521
http://dx.doi.org/10.1038/s41598-023-45606-1
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author Paakkari, Olli
Kulmala, Markus
Lyyra, Nelli
Torppa, Minna
Mazur, Joanna
Boberova, Zuzana
Paakkari, Leena
author_facet Paakkari, Olli
Kulmala, Markus
Lyyra, Nelli
Torppa, Minna
Mazur, Joanna
Boberova, Zuzana
Paakkari, Leena
author_sort Paakkari, Olli
collection PubMed
description Health literacy is an asset for and indicator of adolescents’ health and wellbeing, and should therefore be monitored and addressed across countries. This study aimed to develop and validate a shorter version of the original 10-item health literacy for school-aged children instrument in a cross-national context, using data from the health behaviour in school-aged children 2017/18 survey. The data were obtained from 25 425 adolescents (aged 13 and 15 years) from seven European countries. Determination was made of the best item combination to form a shorter version of the health literacy instrument. Thereafter, the structural validity, reliability, measurement invariance, and criterion validity of the new 5-item instrument were examined. Confirmatory factor analysis showed a good model fit to the data across countries and in the total sample, confirming the structural validity (CFI = 0.995, TLI = 0.989, SRMR = 0.011, RMSEA = 0.031). The internal consistency of the instrument was at a good level across countries (α = 0.87–0.98), indicating that the instrument provided reliable scores. Configural and metric invariance was established across genders, ages, and countries. Scalar invariance was achieved for age and gender groups, but not between countries. This indicated that the factor structure of the scale was similar, but that there were differences between the countries in health literacy levels. Regarding criterion validity, structural equation modelling showed a positive association between health literacy and self-rated health in all the participating countries. The new instrument was found to be valid and reliable for the purposes of measuring health literacy among adolescents in a cross-national context.
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spelling pubmed-106184932023-11-02 The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument Paakkari, Olli Kulmala, Markus Lyyra, Nelli Torppa, Minna Mazur, Joanna Boberova, Zuzana Paakkari, Leena Sci Rep Article Health literacy is an asset for and indicator of adolescents’ health and wellbeing, and should therefore be monitored and addressed across countries. This study aimed to develop and validate a shorter version of the original 10-item health literacy for school-aged children instrument in a cross-national context, using data from the health behaviour in school-aged children 2017/18 survey. The data were obtained from 25 425 adolescents (aged 13 and 15 years) from seven European countries. Determination was made of the best item combination to form a shorter version of the health literacy instrument. Thereafter, the structural validity, reliability, measurement invariance, and criterion validity of the new 5-item instrument were examined. Confirmatory factor analysis showed a good model fit to the data across countries and in the total sample, confirming the structural validity (CFI = 0.995, TLI = 0.989, SRMR = 0.011, RMSEA = 0.031). The internal consistency of the instrument was at a good level across countries (α = 0.87–0.98), indicating that the instrument provided reliable scores. Configural and metric invariance was established across genders, ages, and countries. Scalar invariance was achieved for age and gender groups, but not between countries. This indicated that the factor structure of the scale was similar, but that there were differences between the countries in health literacy levels. Regarding criterion validity, structural equation modelling showed a positive association between health literacy and self-rated health in all the participating countries. The new instrument was found to be valid and reliable for the purposes of measuring health literacy among adolescents in a cross-national context. Nature Publishing Group UK 2023-10-31 /pmc/articles/PMC10618493/ /pubmed/37907521 http://dx.doi.org/10.1038/s41598-023-45606-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Paakkari, Olli
Kulmala, Markus
Lyyra, Nelli
Torppa, Minna
Mazur, Joanna
Boberova, Zuzana
Paakkari, Leena
The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument
title The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument
title_full The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument
title_fullStr The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument
title_full_unstemmed The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument
title_short The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument
title_sort development and cross-national validation of the short health literacy for school-aged children (hlsac-5) instrument
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618493/
https://www.ncbi.nlm.nih.gov/pubmed/37907521
http://dx.doi.org/10.1038/s41598-023-45606-1
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