Evaluation of the Japanese version of HLS-Q12 in older adults

Abstract

Objectives The purpose of this study was to evaluate the internal consistency and factorial validity of the Japanese version of HLS-Q12 health literacy rating scale when used with older adults.Methods A questionnaire-based mail survey was conducted among older adults living in a community. The data collection period was from January to February 2022. The Japanese version of HLS-Q12 was used to obtain data on health literacy of older adults, and the internal consistency and factorial validity of the scale were evaluated using Cronbach's alpha coefficient and confirmatory factor analysis, respectively. In addition, a Rasch model was used to conduct a detailed analysis on each questionnaire item.Results Questionnaires were distributed among 3,572 people, out of which, 1,082 responses were received from older adults (over 65 years of age). Cronbach's alpha coefficient was 0.8 or higher, indicating no internal consistency issues. According to the confirmatory factor analysis, CFI was equal to 0.933, AGFI, 0.876, and RMSEA, 0.092; thus, all indicators met certain evaluation levels. However, deviation from one of the multiple fit criteria was confirmed for the value of RMSEA, indicating that the error between the estimated value calculated by the scale and the true value was relatively large. Analysis of each question item using the Rasch model showed that all the questions met the criteria of Infit MSQ and were suitable in their question structure.Conclusion Following the evaluation of the HLS-Q12 scale in older adults, the scale was found to be reliable and valid at a certain level. However, the value of RMSEA indicated that it was relatively large in terms of the error between the estimated value calculated by the scale and the true value.