Abstract
Objective:to investigate the psychometric properties of the Brazilian Portuguese version of the health literacy questionnaire European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults.Method:the instrument was translated and pre-tested in a sample of 50 individuals. Subsequently, it was applied to a sample of 783 adult individuals. The data went through an appropriate process of testing the properties, with the combination of techniques of Exploratory Factor Analysis, Confirmatory Factor Analysis and Item Response Theory. For the assessment of reliability, the Cronbach's alpha and McDonald's Omega indicators were used. Cross-validation with full data analysis was applied.Results:the majority of the participants was female (68.1%), with a mean age of 38.6 (sd=14.5) years old and 33.5% studied up to elementary school. The results indicated a unidimensional model with an explained variance of 71.23%, adequate factor load levels, commonality and item discrimination, as well as stability and replicability of the instrument to other populations.Conclusion:the Brazilian version of HLS-EU-Q6 indicated that the instrument is suitable for indiscriminate application in the population to which it is intended to assess health literacy levels.
Highlights
Health Literacy (HL) is a construct related to the use of multiple forms of health information in the most varied contexts(1)
A total of 783 individuals participated in the study, with a mean age of 38.6 (14.5) years old, of which 68.1% (n=533) were female
The results of the present study demonstrated that the Brazilian Portuguese version of HLS-EU-Q6 showed unidimensional characteristics, satisfactory factor loads and good levels of reliability, which point to an instrument with evidence of a consistent and reliable internal structure for measuring the desired construct
Summary
Health Literacy (HL) is a construct related to the use of multiple forms of health information in the most varied contexts(1). There are several definitions, which include personal characteristics, social resources and the role of the health services in this process(1-2), for the World Health Organization (WHO), HL concerns the knowledge, motivations and skills of people to access, understand, judge and apply health information, in order to make decisions that help them navigate the health systems, as well as promote, prevent and care for their health(1). Several instruments have already been developed to measure this construct in individuals and populations(4-5); most assess only the functional characteristics of HL, that is, the personal skills to read and understand written and oral health-related information(1,6). The HLS-EU-Q47 questionnaire assesses individual skills in understanding, evaluating and applying health-related information and was developed based on a conceptual literacy model that integrates three domains: health care (16 questions), health promotion (16 questions) and disease prevention (15 questions). Few studies have used HLS-EU-Q6(7,9-12) and/or evaluated its psychometric properties(13-14), showing the importance of testing it more robustly in other populations
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