Development and Validation of a 15-Item Japanese Health Knowledge Test

BACKGROUND: Health literacy affects the acquisition of health knowledge and is thus linked to health outcomes. However, few scales have been developed to assess the level of health knowledge among the general public. METHODS: The 15-item Japanese Health Knowledge Test (J-HKT) was developed by using item response theory to score an item pool. We examined the construct validity of the J-HKT in relation to health literacy items, and analyzed the sociodemographic and behavioral factors associated with poor health knowledge. RESULTS: We enrolled 1040 adult participants (mean age, 57 years; women, 52%). The 15 items that best identified people with poor health knowledge were selected. For all items on the J-HKT, the information function curves had a peak in the negative spectrum of the latent trait. As compared with participants reporting high levels of income, educational attainment, and literacy, those with low levels of income, education, and literacy had a lower total score on the J-HKT. As compared with non/light drinkers, moderate and heavy drinkers had lower total scores on the J-HKT. CONCLUSIONS: The J-HKT may prove useful in measuring health knowledge among the general public, and in identifying and characterizing those with poor health knowledge.