Abstract
BackgroundHealth literacy has been recognized as an important factor influencing health behaviors and health outcomes. However, its definition is still evolving, and the tools available for its measurement are limited in scope. Based on the conceptualization of health literacy within the Health Empowerment Model, the present study developed and validated a tool to assess patient’s health knowledge use, within the context of asthma self-management.MethodsA review of scientific literature on asthma self-management, and several interviews with pulmonologists and asthma patients were conducted. From these, 19 scenarios with 4 response options each were drafted and assembled in a scenario-based questionnaire. Furthermore, a three round Delphi procedure was carried out, to validate the tool with the participation of 12 specialists in lung diseases.ResultsThe face and content validity of the tool were achieved by face-to-face interviews with 2 pulmonologists and 5 patients. Consensus among the specialists on the adequacy of the response options was achieved after the three round Delphi procedure. The final tool has a 0.97 intra-class correlation coefficient (ICC), indicating a strong level of agreement among experts on the ratings of the response options. The ICC for single scenarios, range from 0.92 to 0.99.ConclusionsThe newly developed tool provides a final score representing patient’s health knowledge use, based on the specialist’s consensus. This tool contributes to enriching the measurement of a more advanced health literacy dimension.
Highlights
Health literacy has been recognized as an important factor influencing health behaviors and health outcomes
In recent years, increasing attention has been paid to the impact of health literacy on people’s health behavior and health outcomes
The overall intra-class correlation coefficient (ICC) for the 76 response options corresponding to the 19 scenarios was 0.97 (Figure 2), and the ICC for the single scenarios ranged from 0.92 to 0.99
Summary
Health literacy has been recognized as an important factor influencing health behaviors and health outcomes. Among the efforts to broaden the early conceptualization of health literacy, the Health Empowerment Model proposes an additional dimension named judgment skills [9] These skills are closely related to the conceptualization of phronesis, introduced in the context of health literacy by Rubinelly et al, [10]. Judgment skills refer to the individual’s abilities to recognize and evaluate when and where to apply a particular knowledge to solve every day problems related with his/her health condition Such abilities come from the individual’s health knowledge, past experience living with the disease, and individual’s ability to adapt to a changing environment, known as practical intelligence [11]. The inclusion of these judgment skills in the conceptualization of health literacy opens a new window to understand individuals’ health behavior
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