Validation of the Short-Test of Functional Health Literacy in Adults for the Samoan Population

BACKGROUND: Health literacy encompasses various levels of communication for an individual, provider, and an organization. Validated and reliable tools have been developed to assess health literacy; however, there is a paucity of tools available to assess health literacy in native languages for indigenous and racial/ethnic minority populations. OBJECTIVE: This article shares the process taken to translate and evaluate validation and reliability of the Short Test of Functional Health Literacy in Adults for use with the Samoan population. METHODS: Respondent-driven sampling was used to collect data from 1,543 adults age 45 years and older in American Samoa. A confirmatory factor analysis using a two-factor model for validation was conducted. KEY RESULTS: The validation results indicated a “good fit” in multiple indices and Cronbach's alpha indicated high internal consistency in both the English and Samoan languages. CONCLUSIONS: Developing culturally validated and reliable health literacy assessment tools is important to help health care professionals decrease health disparities and address inadequate health literacy in all cultures. [HLRP: Health Literacy Research and Practice. 2022;6(4):e247–e256.] PLAIN LANGUAGE SUMMARY: The INSPIRE project studied the Short Test of Functional Health Literacy in Adults (STOFHLA) tested on the American Samoan population age 50 years and older. The results would show if the STOFHLA is a valid tool to measure functional health literacy in American Samoa adults.