European Health Literacy Survey Questionnaire Research Articles

The Impact of Health Literacy on the ERCP Process

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive method commonly used for the diagnosis and treatment of hepatopancreaticobiliary diseases. The aim of this study is to assess whether there is a relationship between Health Literacy (HL) levels and the ERCP process. 
 Material and Methods: The study prospectively evaluated the HL data of 72 patients who had ERCP in our hospital between July-November 2020. The Turkish version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to assess health literacy. The patients’ demographic characteristics, duration of referral to hospital, duration of the ERCP procedure, white blood cells (WBC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), and total-direct bilirubin levels and HLS-EU-Q47 results were recorded and evaluated.
 Results: In our study, 77.7% of the patients had insufficient HL levels. The median body mass index (BMI) was statistically higher in patients with an insufficient HL level (p= .046). GGT, total and direct bilirubin levels were higher in patients with a low HL level (p= .009, p= .031, p= .008, respectively). The assessment of the duration of referral for ERCP revealed that the median duration of referral was statistically significantly longer in patients with an insufficient HL level (p< .001). The median duration of cannulation during ERCP was statistically higher in patients with an insufficient HL level (p= .002).
 Conclusions: The level of Health Literacy affects the early diagnosis and the success of the procedure in hepatopancreaticobiliary diseases that require ERCP.

Health Literacy throughout adolescence: Invariance and validity study of three measurement scales in the general population

ObjectiveTo simultaneously investigate the psychometric properties of three recently developed health literacy measurement scales throughout adolescence in the general population. MethodsFrench versions of the Health Literacy for School-Aged Children (HLSAC, unidimensional) scale, the Health Literacy Assessment Scale for Adolescents (HAS-A, multidimensional) and the 16-item European Health Literacy Survey questionnaire (HLS-EU-Q16, unidimensional) were completed by 1 444 adolescents in 8th, 9th, 11th grade in general school and 11–12th grade in vocational school. Psychometric properties were studied using confirmatory factor analysis, McDonald’s omega coefficient and hypothesis testing. ResultsStructural validity was acceptable (HLS-EU-Q16) to good (HAS-A and HLSAC), no measurement invariance issue was found and internal consistency was acceptable for the three scales (0.68–0.84). Convergent validity was low (Pearson correlation coefficients<0.5) and the only scale for which results were in agreement with a priori hypotheses was the HLSAC. ConclusionsOur results were supportive of the use of HLSAC to assess health literacy during adolescence but the HAS-A, with a slightly better structural validity, can also be promoted due to its three measured dimensions. Practice implicationsThe use of these scales in practice will help to focus on health literacy, a critical factor for prevention and health promotion in adolescence.

The effect of self-efficacy on health literacy in the German population.

Concerning the determinants of health literacy (HL) mostly socio-demographic or -economic factors have been considered, much less so psychological factors such as self-efficacy. To date, it has mostly been considered to explain the relationship of HL and health outcomes. However, self-efficacy could also be an important determinant for HL. This study therefore examines the effect of self-efficacy on comprehensive HL within the general population in Germany. Data from the German HL Survey (HLS-GER), a cross-sectional, computer-assisted personal interview study among 2000 respondents aged 15+ years in 2014 were used. Self-efficacy was measured using the German version of general self-efficacy short scale (ASKU), comprehensive HL was measured using the German version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47). Correlation and multi-variate linear regression analyses were performed to analyze independent effects of socio-demographic factors-age, gender, social status, educational level and migration background-functional HL and self-efficacy on comprehensive HL. Self-efficacy and comprehensive HL are statistically significantly correlated (Spearman's Rho = 0.405; p < 0.01), respondents with better self-efficacy had better HL scores. Both concepts are significantly associated with most socio-demographic factors and functional HL. Self-efficacy showed the strongest association with HL in the multivariate analyses (model 2: β =0.310, p < 0.001). The effect size of the other predictors decreased, when adding self-efficacy into the equation, but remained statistically significant. Self-efficacy is a rather strong predictor of comprehensive HL. Future research and measures to improve HL should therefore take self-efficacy adequately into account.

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

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.

Relationship Between Socio-Demographic Characteristics, Reproductive Health Behaviors, and Health Literacy of Women in Serbia.

Introduction: Health literacy of women can significantly affect different aspects of reproductive health. The aim of this study was the assessment of relationship of health literacy, socio-demographic characteristics and reproductive health behaviors of women in Serbia.Methodology: This was a cross-sectional study on a random sample of women aged 18 and over from the territories of three Serbian regions, stratified according to age groups, region and type of settlement. A standardized version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used in assessing health literacy of women.Results: Based on the calculated index of health literacy, 9.6% of respondents had inadequate health literacy. Inadequate levels of health literacy were more common in women living in rural areas (OR = 1.111) and the poorer classes (OR = 5.122). Employed women (OP = 1.249), with good health (OR = 1.512) with a degree (OR = 1.535) had bigger odds to have adequate health literacy. Multivariate regression analysis showed the following significant predictors: commitment to the chosen gynecologist (OR = 1.530), contraceptive use (OR = 1.020), knowledge of the damages that could be caused by the human papillomavirus (HPV) (OR = 1.578), awareness of vaccine availability against HPV infection (OR = 1.217) and following the health-related topics (OR = 2.350).Conclusion: Limited levels of health literacy were significantly higher among middle-aged women, among those living in rural areas, among women who rated their health as poor or very poor, and who exhibited more negative patterns of reproductive health behavior, indicating the need for implementation of prevention programs and strategies with the aim of increasing the level of health literacy.

Health literacy and cancer screening behaviors among community-dwelling female adults in Taiwan

ABSTRACT This study was designed to explore the association among health literacy and cancer screening behaviors in Taiwanese females. A total of 353 community-dwelling females were recruited in this cross-sectional study from February to October 2015. Demographic, socioeconomic and personal behavior variables including physical activity, community activity, smoking, alcohol consumption, and betel nut chewing were recorded. Health literacy was evaluated using the Mandarin version of the European Health Literacy Survey Questionnaire. Data on screening behaviors for cervical, breast and colorectal cancers were confirmed by the Taiwanese National eHealth Database. Most respondents with inadequate or problematic general health literacy had no or irregular screening behaviors for cervical, breast and colorectal cancers. In multivariable regression analysis, women with inadequate health literacy were at a greater risk (Odds ratio = 5.71; 95% CI: 1.40–23.26) of having no previous Pap smear screening or >3 years screening interval regardless of education level. However, this association was not detected for breast or colorectal cancer. Women with inadequate health literacy were more likely to have irregular cervical cancer screening, however no associations among health literacy and breast or colorectal cancer were detected. The impact of health literacy on cancer screening behavior warrants further attention and research.

Utilizing a Multidimensional Health Literacy Framework to Assess Cervical Cancer Screening Nonadherence.

Health literacy is an amenable factor that can improve screening uptake. However, associations between the multidimensional health literacy domains and cervical cancer screening nonadherence are not known and should be considered to improve screening rates. The current quantitative study assessed the associations of multiple health literacy domains with cervical cancer screening nonadherence. Women aged 30 to 65 years without a hysterectomy were surveyed online (N = 812). Assessing, understanding, and appraising measures from the European Health Literacy Survey Questionnaire were adapted for cervical cancer screening. The outcome variable measured the application of cervical cancer information regarding adherence to the 2012 cervical cancer screening guidelines (yes/no). Adjusted logistic regression odds ratios (aORs) estimated nonadherence. Most of the women were non-Hispanic (81.4%) or White (68.1%), and aged 30 to 39 years (40%). The majority of the women (71%) were adherent to screening recommendations. The model with all domains of health literacy had the best model fit statistics compared with other models with different health literacy components. Older age and lack of insurance were statistically significant for screening nonadherence. Difficulty understanding health information (aOR = 3.15; 95% confidence interval [CI; 1.80, 5.51]) and less worry about cervical cancer (aOR = 1.74; 95% CI [1.03, 2.94]) were associated with higher odds of nonadherence. Higher cervical cancer knowledge (aOR = 0.93; 95% CI [0.87, 0.98]) and Hispanic ethnicity (aOR = 0.36; 95% CI [0.21, 0.61)] were associated with lower odds of nonadherence. Incorporating a multidimensional health literacy framework may better inform the need to develop easily understood interventions that address cervical cancer perceived vulnerability and acknowledge systemic sociodemographic influences on screening perceptions.

Effects of health literacy on frailty status at two-year follow-up in older adults: A prospective cohort study

To investigate the longitudinal association between health literacy and frailty status at two-year follow-up in community-dwelling older adults. A total of 218 older adults (mean age, 72.5±4.9 [range 65-86] years old; men, n=81) without frailty at baseline participated in this study. Functional health literacy was assessed using the Newest Vital Sign (NVS). Comprehensive health literacy was assessed using the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). Comprehensive health literacy indices are constructed as a general health literacy index comprising all items along with the three sub-indices of health care, disease prevention, and health promotion domains. Demographic data and other potential confounding factors were also assessed. The total Kihon checklist score was used to monitor the presence of frailty based on a score of ≥8 at the 2-year follow-up (postal survey). Of the 253 participants in the follow-up survey, 226 responded (response rate: 89.3%). Excluding the 8 participants with missing values, 25 (11.5%) of the 218 were reported to be frail. A multiple logistic regression analysis indicated that comprehensive health literacy (total score of HLS-EU-Q47) was independently associated with a lower risk of frailty (odds ratio per standard deviation = 0.54, 95% confidence interval = 0.33-0.87) after adjusting for the covariates (age, gender, education, body mass index, gait speed, cognitive function, and comorbidities). The health care and disease prevention domain scores of the HLS-EU-Q47 were also independently associated with a lower risk of frailty. Functional health literacy (NVS score) was not associated with frailty. Older adults with higher comprehensive health literacy are less likely to be frail at two-year follow-up than those with a lower literacy.

Psychometric properties of the adapted instrument European Health Literacy Survey Questionnaire short-short form.

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.

Medication adherence, self-efficacy and health literacy among patients with glaucoma: a mixed-methods study protocol

IntroductionAs the world population ages, glaucoma is becoming an increasingly significant cause of blindness. A key component in the management of glaucoma is the use of prescribed medications and the...

Improving the utility of the European Health Literacy Survey Questionnaire: a computerized adaptive test for patients with stroke

Purpose Health literacy among patients is crucial for effective stroke management. The European Health Literacy Survey Questionnaire is a theory-based measure that comprehensively captures 12 domains of health literacy. We aimed to develop a computerized adaptive test of the European Health Literacy Survey Questionnaire to efficiently assess health literacy among patients with stroke. Materials and methods The European Health Literacy Survey Questionnaire data of 311 patients and item parameters were retrieved from a Rasch validation study. Real data simulations were performed to develop a computerized adaptive test of the European Health Literacy Survey Questionnaire and explore its efficiency and reliability. Results The computerized adaptive test of the European Health Literacy Survey Questionnaire displayed suitable reliability in all 12 domains (0.72–0.84) with a mean test length of 17 items (36.2% of the 47-item European Health Literacy Survey Questionnaire). Conclusions Our findings indicate that the computerized adaptive test of the European Health Literacy Survey Questionnaire, which assesses 12 domains of health literacy among patients with stroke in a timely and precise fashion, is efficient and reliable. Implications for rehabilitation The computerized adaptive test of the European Health Literacy Survey Questionnaire assesses the subjective fit of personal health literacy competencies to environmental demands, providing insight into patient strengths and weaknesses when dealing with health tasks and interacting with health systems. The computerized adaptive test of the European Health Literacy Survey Questionnaire assesses the 12 domains of health literacy among patients with stroke in a timely and precise manner. Our study has demonstrated the utility of the computerized adaptive test of the European Health Literacy Survey Questionnaire in reducing the assessment burden of patients in clinical practice. Developing of the computerized adaptive test of the European Health Literacy Survey Questionnaire provided findings that may benefit researchers and clinicians interested in developing efficient outcome measures.

Understanding Parental Health Literacy for Clean and Healthy Behavior in Early Childhood During the Covid-19 Pandemic

In the COVID-19 pandemic scenario, parents need to be familiar with health literacy by applying clean and healthy living habits to their family members, especially those with early childhood. This study aims to explain parents' perceptions of health literacy for a clean and healthy behavior in their children during the COVID-19 pandemic. The method used in this study is a cross-sectional study involving 22 men and 62 female respondents. Respondent requirements were used in data analysis to determine parents' perceptions of health literacy and the efforts they have made to practice clean and healthy lifestyle in their children. The research findings show that knowing the health awareness of parents has an impact on a child's balanced lifestyle. Based on six measures of clean and healthy behavior for children, three indicators were determined in the category of discipline and high discipline: using clean water, using the toilet, and doing physical activity. The act of washing children's hands with soap indicators has a high discipline score and the use of masks in children has low discipline. If the use of masks is not disciplined by parents, exposure to COVID-19 in early childhood can be disrupted.&#x0D; Keywords: Early Childhood, Parental health literacy, Clean and healthy behaviors&#x0D;

Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study

ObjectiveLimited health literacy in patients with type 2 diabetes mellitus (T2DM) led to poorer diabetes knowledge, less medication adherence and increased healthcare cost. The purpose of this paper was to...

Psychometric Assessment of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) for Arabic/French-Speaking Migrants in Southern Europe.

Improving health literacy (HL) is critical for addressing health inequalities. Low literacy rates are believed to be more prevalent in ethnic minorities, which may have an impact on people’s health. For measures to be implemented in this regard, HL must be evaluated to obtain specific indicators. Our aim, therefore, was to develop a version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16), which is recommended to be used with vulnerable populations, suited to Arabic/French-speaking migrants who reside in south-eastern Spain, and to explore its psychometric properties for assessing health literacy in this population. A cross-sectional survey was carried out in a convenient sample of 205 migrants. The structural validity was calculated by a confirmatory factorial analysis (CFA), which suggested appropriate adjustment indicators, and which indicated that the three-dimensional model is adequately adjusted to the data obtained in the study. The coefficient omega showed high internal consistency in the three HL dimensions (health care, disease prevention, and health promotion). Concurrent validity presented a significant correlation with the Newest Vital Sign test (r = 0.390; p < 0.001). The multigroup CFA showed that the heterogeneity of the sample used was not a problem for establishing the structural validity of the scale. The Arabic/French version showed good construct validity.

Measuring health literacy combining performance-based and self-assessed measures: the roles of age, educational level and financial resources in predicting health literacy skills. A cross-sectional study conducted in Florence (Italy)

ObjectiveThe objective was to compare the results of performance-based and self-assessed measures of health literacy (HL) and to evaluate the contribution of their joint use in assessing some HL antecedents.DesignThis...

Effect of health literacy on help-seeking behavior: A comparison of patients accepting surgery and refusing surgery for urinary incontinence

Objective(s)To compare the health literacy (HL) of the adult females with SUI complaints in terms of their acceptance or non-acceptance of surgery. MethodsIn this cohort study, the European Health Literacy Survey Questionnaire (HLS-EU- Q47) scores as a measure of health literacy were compared among the two groups of patients who accepted to undergo surgery for SUI and the ones who did not. Demographic features, weight and BMI values, comorbidity, menopausal status, duration and type of UI, socioeconomic characteristics (marital status, educational level, level of income) and HLS-EU- Q47 survey results of the two groups were compared. We also investigated the reasons regarding the acceptance or refusal of SUI surgery. ResultsAmong the patients who were offered surgery 474% accepted to undergo operation. Total HLS-EU-Q47 score was 30.04 in the group of patients who accepted surgery and 23.46 in the group who refused surgery. The patients that refused surgery had more often insufficient health literacy level (p=0.001). An excellent health literacy level was higher for patients who agreed to anti-incontinence surgery (p=0.021). ConclusionsHealth literacy score of patients with urinary incontinence (UI) who refused surgery was lower than those who accepted surgery. Acceptance of surgery may be increased by providing more understandable and clear information, especially for women with lower HL levels.

Psychometric properties of the Danish version of the European Health Literacy Survey Questionnaire

Abstract Background Understanding and utilizing health information has become increasingly demanding whereby people's health literacy becomes important. European Health Literacy Survey Questionnaire (HLS-EU-Q16) measures health literacy (HL). We aimed to study the psychometric properties of the Danish version in the general population and a population with coronary artery disease. Methods A national, cross-sectional survey of individuals from the general Danish population and patients with Myocardial Infarction (MI) was conducted. The general population sample consisted of 7,653 individuals. The MI sample of 4,440 individuals had previously been hospitalized with MI. To assess the influence of large sample sizes, we examined five randomly drawn subsamples of 500 from each population. The Rasch analysis was conducted using RUMM-2030 consisting of inspection of unidimensionality, local dependency, Differential item Functioning (DIF), and item fit. Results The results are preliminary and analyses still ongoing. The HLS-EU-Q16 did not fit the Rasch model, neither for the total sample, subsamples, the general population sample, nor for the MI sample. For the MI sample, there were signs of local dependence and item 6 had the largest item misfit. DIF was observed for item 6 and 7 (age and gender). The general population sample also showed signs of local dependence, and item 1 indicated the largest item misfit. DIF was observed for item 1 (age) and item 1, 7, 8, 13 and 16 (gender). Conclusions The Danish version of HLS-EU-Q16 did not fit the Rasch model neither in the general population sample nor for the MI sample. Our large population-based study indicated scalability problems of the HLS-EU-Q16. The validation procedure is a step on the path to ensure the use of valid measures of HL in both populations and patient groups to support the raising awareness of HL as a necessary element to ensure equity in our health system and thereby initiating an urgent public health activity. Key messages We studied the construct validity of the Danish version of the European Health Literacy Survey Questionnaire HLS-EU-Q16 with a Rasch model. Our large population-based study indicate problems with the psychometric properties of the current Danish version of the HLS-EU-Q16.

Health literacy among first-generation Italian immigrants in Norway

Abstract Background People with an immigration background often have poorer health than the general population. Italians in Norway have tripled throughout the past 15-years, but little is known about their health. Health literacy (HL) has been emerging as a fundamental construct in enabling citizens to play an active role in improving their own and theirs community's health. The objective of our study was i) to describe HL among first-generation Italian immigrants in Norway, ii) examine the association between HL and health-related empowerment, and iii) compare HL in Italian immigrants with the general Norwegian population's. Methods The data was retrieved from a cross-sectional survey (n = 321) conducted within the study Mens Sana in Corpore Sano (inclusion criteria: age ≥18 years, living in Norway permanently, having lived in Italy at least until age 16). HL was measured using the short form of the European Health literacy survey questionnaire (HLS-Q12; α = 0.83). Empowerment was assessed using a 4-items scale (α = 0.73), developed on basis the World Health Organization's definition of individual empowerment and aspects of patient empowerment. Additionally, information about gender, age, educational level, and self-rated health was collected. Results Preliminary results indicated that 8% had inadequate HL, whereas about 40% had marginal HL. No significant differences in HL were observed in relation to gender, age, education level or general health. A medium correlation was found between HL and empowerment (r = 0.42, p &amp;lt; 0.001). The Italian's HL was significantly lower than the general Norwegian population's (M±SD = 32.46±4.79 and 33.11 ± 4.12, respectively; p = 0.028). Conclusions This is the first study investigating HL and its associations with the health-related empowerment of first-generation Italian immigrants in Norway. More research is needed in order to better understand this phenomenon as well as the effectiveness of HL-enhancing initiatives. Key messages We investigated the levels of health literacy and health-related empowerment among first-generation Italian immigrants in Norway. The Italians’ heath literacy, which correlated with empowerment, was lower than the general Norwegian population’s. There were no differences across gender, age, education level or general health.

Exploring Health Literacy in Individuals with Alcohol Addiction: A Mixed Methods Clinical Study.

This mixed methods research paper explores health literacy (HL) in individuals with alcohol addiction by using the 47-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and semi-structured interviews concerning health-related competencies (access, understand, appraise, and apply health information), and determines the limitations of the HLS-EU-Q47 when used under specific conditions of clinical practice. The questionnaire survey and the interviews were conducted with individuals of different health literacy levels who were undergoing inpatient alcohol addiction treatment. The findings indicate that individuals with alcohol addiction might require different types of health information according to their health literacy level in terms of quantity and quality of information to recover from alcohol addiction and improve their overall health. The implications for the clinical practice of addiction treatment as well as recommendations for national and regional policy are also discussed.

Adaptation of HLS-EU-Q47 for the Russian population

Abstract Background Health literacy (HL) is recognized as one of the major determinants of health. International population HL surveys in Europe and Asia using a unified measurement of European Health Literacy Survey Questionnaire (HLS-EU-Q) demonstrated similar results of approximately 50% of population having poor or problematic health literacy level. In the present study the HLS-EU Q47 was adapted for the Russian population for the first time. Russian language is spoken widely beyond the Russian Federation (RF). Among international migrants, more than 25 million are from the RF or former Soviet Union, typically speak Russian and have a common historical and cultural background. Methods Adaptation of the questionnaire was based on the HLS-EU methodology and included 5 stages: translation from English into Russian, back translation by two independent translators, focus group (n = 12), online expert opinion (n = 12), field-testing (n = 90). For the focus group, the purposeful sampling was used, stratified by gender, age, education level and place of living (urban/rural). The field-testing was conducted by personal interviews in households, using a random stratified sampling based on gender and age. Results The translations analysis identified discrepancies on the use of plain language, and allowed to simplify the wording in 10 questions (13%). The focus group and expert opinion qualitative analysis allowed identifying and adapting cultural and linguistic peculiarities, so 24 questions (31%) were adapted. The field-testing showed 86% feasibility of the questionnaire in real settings. Conclusions Despite that the instrument was translated into Russian and used in some countries for the Russian-speaking population, a substantial adaptation of the questionnaire is necessary, taking into account the cultural and linguistic characteristics and background of the studied population. The instrument can contribute for measurement of HL in Russian population living in different countries. Key messages The HLS-EU-Q 47 was adapted for the Russian population. The adapted instrument can contribute to further health literacy measurements of the Russian population worldwide.