Development of a Hypertension Health Literacy Assessment Tool for use in primary healthcare clinics in South Africa, Gauteng

BACKGROUND: Hypertension is a universal risk factor for cardiovascular morbidity and mortality in both the ageing and obese populations and patients must be literate in hypertension health issues to participate actively in the management of their disease. Little research has been done to investigate hypertension health literacy levels among South Africans. AIM: To develop a Hypertension Heath Literacy Assessment Tool to establish patients’ comprehension of the health education they receive in primary healthcare (PHC) clinics in Tshwane, Gauteng, South Africa. SETTING: PHC clinics in Tshwane, Gauteng, South Africa. METHODS: The design was quantitative, descriptive and contextual in nature. The study population comprised health promoters who were experts in the field of health, documents containing hypertension health education content and individuals with hypertension. Participants were conveniently and purposefully selected. A modified Delphi technique was used to develop and validate the Hypertension Health Literacy Assessment Tool (HHLAT). To ensure validity and reliability of the HHLAT, the tool was administered to 195 participants concurrently with the Learning Ability Battery (LAB). RESULTS: There was a strong positive (F = 76.0, p < 0.0001, R(2) = 28.25%) correlation between the LAB and the HHLAT. The HHLAT indicated that only 37 (19%) of the patients with hypertension had poor hypertension health literacy levels. CONCLUSION: The HHLAT is a valid tool that can be used in busy PHC clinics as it takes less than two minutes to administer. This tool can inform the healthcare worker on the depth of hypertension health education to be given to the patient, empowering the patient and saving time in PHC facilities.