Measuring and Exploring Children's Health Literacy in The Netherlands: Translation and Adaptation of the HLS-Child-Q15.

Marla T H Hahnraths,Monique Heijmans,Maartje Willeboordse,Torsten M Bollweg,Orkan Okan,Jany Rademakers

doi:10.3390/ijerph18105244

Abstract

As health literacy (HL) is hypothesized to develop throughout life, enhancement during childhood will improve HL and health during life. There are few valid, age-appropriate tools to assess children’s HL. The German-language European Health Literacy Survey Questionnaire Adapted for Children (HLS-Child-Q15-DE) is a self-report questionnaire adapted from the adult European Health Literacy Survey Questionnaire. This study aims to translate the HLS-Child-Q15 to Dutch and explore the sample’s HL distribution. The HLS-Child-Q15-DE was translated following WHO guidelines and administered digitally to 209 Dutch schoolchildren (eight-to-eleven-year-olds). Its psychometric properties were assessed and the sample’s HL distribution was explored by demographic characteristics. The HLS-Child-Q15-NL had high internal consistency (α = 0.860) and moderate to strong item-total correlations (mean = 0.499). For 6 of the 15 items, >10% of participants answered “do not know”, indicating comprehension problems. Higher HL scores were observed for ten-to-eleven-year-olds (compared with eight-to-nine-year-olds; p = 0.021) and fourth-grade students (compared with third-grade; p = 0.019). This supports the idea that HL evolves throughout life and the importance of schools in this process. With the HLS-Child-Q15-NL, a Dutch measurement instrument of children’s HL is available, although it needs further tailoring to the target group. More research is needed to decrease comprehension problems and to investigate retest reliability and construct validity.

Highlights

Introduction iationsHealth literacy (HL) is defined as “people’s motivation, knowledge and competences to access, understand, appraise, and apply health information to make judgements and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve quality of life throughout life” [1]
Six participants were excluded from analyses due to having selected “do not know” ≥14 times, resulting in 209 participants included in the present study
Adult guidance might be beneficial for successful administration, excessive adult interference should be avoided to minimize influencing children’s answers

Summary

Introduction

Health literacy (HL) is defined as “people’s motivation, knowledge and competences to access, understand, appraise, and apply health information to make judgements and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve quality of life throughout life” [1]. As HL is hypothesized to be a skill that develops throughout life, enhancing it at a young age (when various prerequisite competencies for HL evolve) will likely result in improved HL and health outcomes later in life [4,5,6]. Little knowledge is available on children’s HL; partly due to the fact that until recently, children and adolescents generally have been overlooked in health research [7].

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