Abstract
The study aimed to illustrate the constructs and test the psychometric properties of an instrument of health literacy competencies (IOHLC) for health professionals. A multi-phase questionnaire development method was used to develop the scale. The categorization of the knowledge and practice domains achieved consensus through a modified Delphi process. To reduce the number of items, the 92-item IOHLC was psychometrically evaluated through internal consistency, Rasch modeling, and two-stage factor analysis. In total, 736 practitioners, including nurses, nurse practitioners, health educators, case managers, and dieticians completed the 92-item IOHLC online from May 2012 to January 2013. The final version of the IOHLC covered 9 knowledge items and 40 skill items containing 9 dimensions, with good model fit, and explaining 72% of total variance. All domains had acceptable internal consistency and discriminant validity. The tool in this study is the first to verify health literacy competencies rigorously. Moreover, through psychometric testing, the 49-item IOHLC demonstrates adequate reliability and validity. The IOHLC may serve as a reference for the theoretical and in-service training of Chinese-speaking individuals’ health literacy competencies.
Highlights
The World Health Organization [1] defined health literacy as the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health
Through factor analysis and Item response theory (IRT), 92 items were simplified into the 49-item instrument of health literacy competencies (IOHLC) that is
The value in diagonal element is the square root of average variance extraction (AVE) of each construct; all correlation coefficients were statistically significant at p < .001. doi:10.1371/journal.pone.0172859.t006
Summary
The World Health Organization [1] defined health literacy as the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health. The important effects of an adequate level of health literacy on the disease management process have been observed in various studies [2,3,4] and drew the attention of health professionals towards successful care for people with chronic disease. Many reports have highlighted that low health literacy is associated with poor communication between patients and healthcare providers and with poor health outcomes, including increased hospitalization rates [7], poor medication adherence [4], and low effective self-care behavior [2]. The landmark report of the Institute of Medicine (IOM) [8] explicitly recommends that health professionals receive training in tailed patient education programs and in communicating effectively with patients with limited health literacy. Health education efforts could enhance people’s health literacy, thereby encouraging health-promoting behaviors [9]
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