Literacy Instrument Research Articles

Exploratory Factor Analysis (EFA) and Reliability Analysis of Financial Literacy Instrument Among Trainee Teachers

Exploratory Factor Analysis (EFA) and Reliability Analysis of Financial Literacy Instrument Among Trainee Teachers

Supporting health education policies: translation, cross-cultural adaptation and validation of a health literacy instrument, in French.

Oral health is a fundamental human right and is inseparable and indivisible from overall health and well-being. Oral Health Literacy (OHL) has been proved to be fundamental to promoting oral health and reducing oral health inequalities. To our knowledge, no OHL instrument to evaluate OHL level is currently validated in French language despite the fact it is the fifth most widely spoken languages on the planet. The Oral health literacy Instrument (OHLI) appears to be the most interesting OHL instrument to adapt into French because it is already available in English, Spanish, Russian, Malaysian, and it contains both reading comprehension and numeracy sections. Its psychometric properties have been rated as adequate. The aim of this study was to translate and adapt cross-culturally the OHLI into French, to evaluate its psychometric properties and to compare its results to oral health knowledge. This study followed and applied well-established processes of translation, cross-cultural adaptation and validation, based on the recommendations of the World Health Organization guidelines and on the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) study design checklist for patient-reported outcomes. Two psychometric assessments were planned, the comparison of OHLI-F scores according to education level and frequency of dental visits, and the test-retest reliability of the OHLI-F. A total of 284 participants answered the OHLI-F. The OHLI-F scores were significantly different between participants with different levels of education and frequency of dental visits (p < 0.001). Participants with an education level lower than the baccalaureate, and those who never visit the dentist or only in case of pain, had significantly lower OHLI-F scores. Internal consistency was excellent (Cronbach's alpha = 0.881-0.914). Test-retest reliability was very high (intraclass correlation = 0.985 to 0.996). The OHLI-F has demonstrated adequate psychometric properties and can therefore be used to measure oral health literacy in French-speaking populations.

Transformasi Informasi pada Literasi Digital di Desa Dengan ISO 29995:2021

The development of technology and information has changed how people communicate today, leading to the digital concept. The use of digital concepts must begin with an assessment of digital literacy through valid measuring tools. This research aims to make ISO 29995:2021 the basis for making valid measuring instruments for digital literacy, especially in the village context. The research method in this study used PRISMA (Preferred Reporting Items for Systematic Review and Meta-analyses) by screening 988 articles based on inclusion and exclusion criteria, resulting in 8 articles that were further analyzed. The results show no valid digital literacy instrument was used in the village context. ISO 29995:2021 can be recommended as one of the cornerstones in creating valid instruments.

Fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana

Objective: to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. Methods: a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. Results: age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. Conclusion: this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.

Factors that influence health literacy in patients with coronary artery disease.

to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.

Understanding Physical Literacy of Physical Education Teachers

The purpose of this study is to ascertain how well physical education teachers comprehend physical literacy. The "perceived physical literacy instrument" (PPLI), which has nine items and a validity level of 0.82, is used to test one's comprehension of physical literacy (very good). Purposive sampling is a strategy used to obtain data. A questionnaire based on the PPLI instrument was distributed to 53 physical education instructors in the Jember area in order to gather knowledge data on physical literacy. Overall survey findings revealed that out of 187 questions, (18.86%) of respondents Sangat Setuju d, (42.7%) of respondents Setuju d there were 204 questions, and (18.86%) of respondents indicated they were unsure about the answers to 90 questions. The results indicate that some teachers have a limited grasp of the idea of physical literacy. This explains why physical education lessons must help teachers better comprehend and cultivate physical literacy. Even if physical education instructors' degree of understanding of physical literacy is known, other measurements must be taken to determine the total competency in physical literacy, such as physical competence, motivation, and self-confidence. Given that there are four areas of physical literacy that might be explored or investigated in the future.

Research into the relationship between digital health literacy and healthy lifestyle behaviors: an intergenerational comparison.

Digital health literacy wields a pivotal role in individuals' health status in terms of seeking and choosing appropriate and accurate information, and useful services from a vast array of choices. This study is aimed at assessing the validity and reliability of the Turkish version of Digital Health Literacy Instrument (DHLI) and examining the relationship between DHL and the healthy lifestyle behaviors of participants from X, Y, and Z generations. In this study, to conduct a cross-sectional web-based survey, an online self-report questionnaire was built, and a convenience sample with a snowball approach was used. The study was conducted among 1,274 respondents aged between 18 and 64 years. Data collection tools consisted of the Personal Information Form, Lifestyle Behavior Scale II (HLBS II), and DHLI. Cultural validation and psychometric testing of DHLI, exploratory factor analysis, confirmatory factor analysis, Cronbach's alpha test, and bivariate and multivariate regression analysis were used for statistical analysis. In the study, the Turkish version of the DHLI tool consisting of six dimensions proved to be valid and reliable, and deemed appropriate for use across all age groups. The average digital health literacy of the respondents was sufficient, but the mean of healthy lifestyle behavior scores was moderate. There was a positive significant relationship between the total mean scores of DHLI and HLBS. Among the subdimensions of DHLI, while the highest mean scores were in DHLI Reliability, DHLI Privacy, and DHLI Search, DHLI Navigation and DHLI Relevance showed the lowest mean scores. DHLI Reliability, DHLI Relevance, and DHLI Adding Content were statistically significant predictors of health-related behaviors of the respondents. The most important feature and novelty of this study is that, although the DHLI scale has been widely translated for use in many countries, it has been translated and adapted to Turkish for the first time herein. The study offers crucial evidence about Generation X, Y, and Z's DHL level and its positive relationships with health-related behaviors. Therefore, the community and its partners should lead the way in empowering individuals to understand and use online information in an effective, secure, and health-promoting manner, along with governments.

Direct Experience of Nature as a Predictor of Environmentally Responsible Behaviors

A small but growing body of literature suggests that outdoor experiences during childhood affect environment-related behaviors in adulthood. However, research on the magnitude of the effect (effect size) of outdoor experience on learners’ behaviors remains scarce. In this study, we explored the extent to which outdoor experiences are associated with environmentally responsible behaviors. Our sample consisted of 143 ninth- and tenth-grade students living on a Greek island. The data were collected using a properly adjusted environmental literacy instrument. Two different methodological pathways, i.e., a quasi-experimental approach and correlation analysis, were used to analyze the data. A tentative variable representing the frequency and intensity of students’ experiential contact with nature was found to be the strongest available predictor of their self-reported pro-environmental behaviors. The findings of this study support the significance of outdoor, experiential learning during childhood in shaping individuals’ environmental behaviors.

Development of Literacy and Numeracy-Based Assessment Instruments for Madrasah Ibtidaiyah Teacher Education Students

This study aims to develop a good literacy and numeracy-based assessment instrument and the implementation of instrument of the assessment is expected to measure the literacy and numeracy skills of Madrasah Ibtidaiyah Teacher Education UIN Walisongo students. The development procedure in this study adopts the Cennamo and Kalk development reseachr program (R&amp;D) model with steps (1) defining phase, which includes literature study and preliminary observation; (2) the planning phase in the form of the preparation of 30 questions of literacy and numeracy-based assessment instruments; (3) the demonstration phase in the form of a theoretical test of the validity of the question by the expert; (4) the development phase in the form of improving questions based on validators' suggestions and conducting question implemented to number of 35 students to determine empirically valid questions; and (5) the phase of presenting theoretically and empirically valid question instruments as many as 19 questions on a broader scale with 42 students and determining the level of literacy and numeracy skills of students. The selected sample population was students of Madrasah Ibtidaiyah Teacher Education UIN Walisongo Semarang, third-semester class of 2020/2021. Sampling is carried out by purposive sampling technique. The result concludes that the assessment instrument developed meets the criteria of feasible and valid theoretically and empirically. The literacy and numeracy skills of PGMI UIN Walsiongo students in the low category are seen from the analysis of the six literacy and numeracy indicators.

The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument

Health literacy is an asset for and indicator of adolescents’ health and wellbeing, and should therefore be monitored and addressed across countries. This study aimed to develop and validate a shorter version of the original 10-item health literacy for school-aged children instrument in a cross-national context, using data from the health behaviour in school-aged children 2017/18 survey. The data were obtained from 25 425 adolescents (aged 13 and 15 years) from seven European countries. Determination was made of the best item combination to form a shorter version of the health literacy instrument. Thereafter, the structural validity, reliability, measurement invariance, and criterion validity of the new 5-item instrument were examined. Confirmatory factor analysis showed a good model fit to the data across countries and in the total sample, confirming the structural validity (CFI = 0.995, TLI = 0.989, SRMR = 0.011, RMSEA = 0.031). The internal consistency of the instrument was at a good level across countries (α = 0.87–0.98), indicating that the instrument provided reliable scores. Configural and metric invariance was established across genders, ages, and countries. Scalar invariance was achieved for age and gender groups, but not between countries. This indicated that the factor structure of the scale was similar, but that there were differences between the countries in health literacy levels. Regarding criterion validity, structural equation modelling showed a positive association between health literacy and self-rated health in all the participating countries. The new instrument was found to be valid and reliable for the purposes of measuring health literacy among adolescents in a cross-national context.

Preparing for the future of healthcare: Digital health literacy among medical students in Lahore, Pakistan.

Digital Health Literacy (DHL) is becoming a cardinal competence for all healthcare professionals (HCPs) including medical students for meaningful digital transformation of healthcare. As medical students need to navigate an increasingly digitalized healthcare environment, thus the study's objective was to assess digital health literacy among medical students. This cross-sectional analytical study was conducted at King Edward Medical University, Lahore from October 2022 to August 2023. Medical students were asked to complete a pen and paper questionnaire of the Digital Health Literacy Instrument (DHLI) after informed consent. DHLI covers seven categories: operational skills, information searching strategy, analyzing the usefulness of online information, navigational abilities, contributing user-generated material to internet-based platforms, and privacy protection. SPSS was used for data analysis. Eight hundred ninety one medical students, from first year to final year, participated in the study. The overall mean score for DHL was 63.5 (SD=8.82). Medical students achieved a score of 83.2% of total score in their operational abilities, and 82.3% proficiency in privacy protection, which were deemed highly desirable. Furthermore, they achieved a satisfactory level in navigation skill (76.0%), information searching (73.1%), adding content (71.0%), determining the significance of data (70.1%), and assessing data reliability (68.7%), based on the overall score. A significant relationship was observed between the performance level of DHL domains and gender with higher scores in males in all domains except protecting privacy, which was higher in females and clinical years students (p-value < 0.05). The assessment of the DHL of medical students was deemed desirable. But certain obstacles were encountered in few domains of DHL i.e., data reliability, relevance determination, and content augmentation. It is imperative to elevate the level of DHL of medical students to harness the potential of digital technologies in enhancing healthcare.

Measuring digital health literacy in children and adolescents

Abstract The talk will address the different digital health literacy instruments currently existing and present their advantages and limitations. The rapid growth in access and use of digital (health) information resources in our society can also be observed among adolescents and children. However, to date no instrument exists that was specifically designed to measure how children and adolescents find, understand, appraise, and use such digital health information and services. The aim of the talk is to provide an overview of digital literacy instruments and present strengths and limitations of existing instruments. One limitation, the self-reported nature of digital health literacy, will be addressed and potential solutions discussed with the audience. The talk will demonstrate the current lack of instruments to measure digital health literacy in children and adolescents, and what this means for child and adolescent public health and the promotion of digital health literacy.

Adaptation of the Digital Health Literacy Instrument and testing with German school-aged children

Abstract Background Children and adolescents in particular navigate in the digital space intensively and use the Internet, social media, and apps to seek health related information. From a public health perspective, the increasing amount of online-based information requires them to possess the abilities to find, understand, evaluate, and apply health information, making digital health literacy more and more important. The Digital Health Literacy Instruments (DHLI) is a psychometrically tested instrument for assessing digital health literacy in adults, which has been adapted for children and adolescents in the United States, using cognitive interviews. However, this version has not yet been adapted for Germany. Hence, the aim of this study is to adapt and test a German version of DHLI for secondary schoolchildren. Methods The pretest tool was translated into German by three native speakers. To test the translated version of the DHLI adapted for secondary schoolchildren, cognitive pretests were conducted with N = 12 children and adolescents aged 10-17 years. The thinking aloud method and probing questions were used during the pretests. The aim of the evaluation was to maximize usability and comprehensibility of the adapted version for schoolchildren in Germany. Results In order to adapt the instrument for a German target group, preferred synonyms were identified during the pretests, as well as a preferred word collocation for health information, namely ‘information about health,’ which was used consistently for all items. Furthermore, two explanations were added in one instruction and one item. Conclusions Based on the results of the pretest analysis, a German version of the DHLI for children and adolescents is now available. Psychometric properties and the methodological quality of the schoolchildren's version of the DHLI have been analyzed in a representative quantitative study, shown in the subsequent presentation.

EHealth literacy among hospital health care providers: a systematic review

BackgroundeHealth literacy is a key concept in the implementation of eHealth resources. However, most eHealth literacy definitions and frameworks are designed from the perceptive of the individual receiving eHealth care, which do not include health care providers’ eHealth literacy or acceptance of delivering eHealth resources.AimsTo identify existing research on eHealth literacy domains and measurements and identify eHealth literacy scores and associated factors among hospital health care providers.MethodsThis systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. A systematic literature search was conducted in MEDLINE, Cinahl, Embase, Scopus, PEDro, AMED and Web of Science. Quantitative studies assessing eHealth literacy with original research, targeting hospital health care providers were included. Three eHealth literacy domains based on the eHealth literacy framework were defined a priori; (1) Individual eHealth literacy, (2) Interaction with the eHealth system, and (3) Access to the system. Pairs of authors independently assessed eligibility, appraised methodological quality and extracted data.ResultsFourteen publications, of which twelve publications were conducted in non-Western countries, were included. In total, 3,666 health care providers within eleven different professions were included, with nurses being the largest group. Nine of the included studies used the eHealth literacy scale (eHEALS) to measure eHealth literacy, representing the domain of individual eHealth literacy. A minority of the studies covered domains such as interaction with the eHealth system and access to the system. The mean eHEALS score in the studies ranged from 27.8 to 31.7 (8–40), indicating a higher eHealth literacy. One study reported desirable eHealth literacy based on the Digital Health Literacy Instrument. Another study reported a relatively high score on the Staff eHealth literacy questionnaire. eHealth literacy was associated with socio-demographic factors, experience of technology, health behaviour and work-related factors.ConclusionsHealth care providers have good individual eHealth literacy. However, more research is needed on the eHealth literacy domains dependent on interaction with the eHealth system and access to the system. Furthermore, most studies were conducted in Eastern and Central-Africa, and more research is thus needed in a Western context.Trial registrationPROSPERO International Prospective Register of Systematic Reviews (CRD42022363039).

Teaching digital health literacy skills in schools: A quantitative study among teachers

Abstract Background In societies increasingly characterized by media and information diversity, digital health literacy (DHL) is an essential key competence for public health. Due to their educational mandate, schools are an important setting for the promotion of DHL, with teachers playing an important facilitating role. While there are findings available on generic health literacy of teachers, evidence is lacking regarding their DHL and the level of teaching DHL in schools. Methods An online survey using a non-probability sample of school teachers in Germany was carried out (N = 1,600). DHL was measured using a translated version of the adult Digital Health Literacy Instrument (DHLI) tool. The level of teaching DHL was assessed using self-developed items based on the seven DHLI dimensions. Descriptive analyses and chi-square tests were conducted in SPSS. Results A large number of teachers reported the level of teaching DHL to be problematic (45,5%) or even inadequate (22,2%). While operational skills, e.g., using a keyboard, are the most likely to be taught in the context of seeking health information, 31% of teachers reported that these skills were not or hardly addressed at their school. Adding self-generated health content, e.g., how to create health-related messages on social media, is the least taught skill, 81% reported that this is taught hardly or not at all. The degree to which DHL is taught is associated with their age (p &amp;lt; .048), school position (p &amp;lt; .001), and own DHL (p &amp;lt; .001), which was found to be low for 44% of teachers. Conclusions The results show that hardly any DHL content is taught in German schools. However, as teaching of DHL in school plays a significant role in student DHL, it should be integrated more often into teaching and learning situations. The links between teacher DHL and the degree to which DHL is taught suggest that teachers’ DHL should be systematically promoted. Education policies in Germany should support incorporating DHL into the curriculum.

Cross-Sectional Association between Perceived Physical Literacy and Mediterranean Dietary Patterns in Adolescents: The EHDLA Study.

The objective of the current study was to analyze the relationship between perceived physical literacy (PPL) and adherence to the Mediterranean Diet (MedDiet) and its specific components in a sample of Spanish adolescents. In this cross-sectional study, we examined a sample of 845 adolescents (58.1% boys) aged 12-17 years from the Valle de Ricote (Region of Murcia, Spain). PPL was assessed by the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). To assess adherence to the MedDiet, the Mediterranean Diet Quality Index in children and adolescents (KIDMED) was applied. In unadjusted analyses, adolescents with medium or high PPL were more likely to have optimal adherence to the MedDiet (medium PPL: OR = 1.69, 95% CI 1.20-2.40, p-adjusted = 0.003; high PPL: OR = 2.90, 95% CI 2.03-4.17, p-adjusted < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, body mass index, energy intake, overall sleep duration, physical activity, and sedentary behavior (medium PPL: OR = 1.51, 95% CI 1.05-2.19, p-adjusted = 0.003; high PPL: OR = 2.27, 95% CI 1.53-3.39, p-adjusted < 0.001). PPL could play a relevant role in the adoption of healthy eating habits among adolescents. Adolescents with low or medium PPL were less likely to report optimal adherence to the MedDiet. Adolescents with high PPL seem to consume more fruits, vegetables, fish, pulses, nuts, and dairies (for breakfast). Conversely, these adolescents tend to skip breakfast less, as well as to consume less commercially baked goods or pastries at this meal.

Psychometric validation of the Chinese digital health literacy instrument among Chinese older adults who have internet use experience.

In this digital age, the Internet has become a major source of health information, and electronic health (eHealth) literacy becomes increasingly important for older individuals to properly use the extensive eHealth resources for self-care. A valid and reliable tool for assessing older people's eHealth literacy would help healthcare workers identify those disadvantaged groups in digital health and provide relevant health education. This study aimed to evaluate the psychometric properties of the Chinese version of DHLI in assessing eHealth literacy among older adults in China. A web-based, cross-sectional study was conducted among 277 Chinese older adults from September to November 2021. Two weeks after the first completion, 62 of them answered the C-DHLI again. The reliability (e.g. internal consistency and test-retest reliability), factorial structure and validity (i.e. content validity and convergent validity) of the C-DHLI were evaluated based on the survey data. The results demonstrated good internal consistency (Cronbach's alpha: 0.94) and test-retest reliability (total intraclass correlation coefficient [ICC]: 0.94) of the C-DHLI. Principal component analysis revealed that the 18 items of C-DHLI loaded on three factors, accounting for 74.69% of the total variance; CFA supported its three-factor structure with good model fits. Convergent validity was examined by the significant associations between C-DHLI and C-eHEALS (r = 0.61), health literacy (r = 0.56), and whether having used the Internet for health information (ρ = 0.43) (ps <.001). A cut-off score of 45 was recommended for determining higher and lower literacy using the C-DHLI, with the area under curve of 0.82 (95% CI = 0.77-0.88). The C-DHLI showed good psychometric performance in assessing eHealth literacy among Chinese older adults. The findings can support healthcare professionals to effectively measure eHealth literacy among older adults and conduct tailored eHealth interventions or training.

Validation of the HeLD-14 functional oral health literacy instrument in a general population.

Oral health literacy (OHL) is recognized as an important determinant of oral outcomes. Measuring OHL with a valid and reliable instrument that accurately captures the functional nature of this construct across cultures is needed. The short version of the Health Literacy in Dentistry scale (HeLD-14) shows promise as an appropriate instrument due to its inclusion of comprehensive domains hypothesized to comprise OHL. While studies validating the instrument in several languages have occurred, the number of dimensions in the various analyses range from one to seven. Validation of the HeLD-14 in a general English-speaking population is also lacking. The purpose of this study was to explore and confirm the dimensionality of the HeLD-14 in a general US English-speaking population. The psychometric properties of HeLD-14 were evaluated in a sample of 631 participants attending the Minnesota State Fair. Construct validity was assessed using exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) on the data set split into two groups. Internal consistency reliability was assessed using the Cronbach's alpha coefficient. Concurrent validity was established between the HeLD-14 and the Oral Health Inventory Profile (OHIP-5) using Pearson's correlation. EFA found, and CFA reinforced, a unidimensional structure of the HeLD-14. Cronbach's alpha was acceptable at 0.92. Fit assessment also supported a unidimensional structure, comparative fit index = 0.992, Tucker-Lewis index = 0.991, root mean square error of approximation = 0.065, and standardized root mean square residual = 0.074. Concurrent validity analyses showed that the HeLD-14 correlated with the OHIP-5. The HeLD-14 is a unidimensional reliable and valid instrument for measuring the oral health literacy in the general US English-speaking adult population.

Who Communicates Well with Data: Examining Data Literacy among Pre‐service Secondary Teachers

ABSTRACTThe current study developed a data literacy instrument with 20 contextual questions and conducted a multi‐mode survey with 232 pre‐service secondary teachers in a university system. Three‐way ANOVA was used to test whether pre‐service teachers with different characteristics (i.e., field of study, library use, and Internet use) performed differently on data literacy. Pre‐service teachers got a decent overall percentage score. They performed better in “identifying problems” and “analyzing data” than in “transforming data” and “collecting data.” While pre‐service teachers in humanities and social sciences performed better in “identifying problems,” those in sciences performed better in “analyzing data.” Humanities pre‐service teachers with high Internet use scored significantly lower; social science pre‐service teachers with high Internet use and low library use scored significantly lower; science pre‐service teachers with low library use scored higher. Implications for future data literacy education and instrument design are discussed based on the preliminary findings.

Psychometric evaluation of the Persian version of the European Health Literacy Instrument (P-HLS-EU-Q47).

Health literacy is one of the most critical determinants of health for effectively improving health services and reducing health inequalities. The importance of accurate measurement cannot be overstated. The European 47-item Health Literacy Questionnaire (HLS-EU-Q47) can provide precise measurements of health literacy. Therefore, this study aimed to evaluate the psychometric properties of the European Health Literacy Instrument in Iranian society (HLS-PV-Q47) for its Persian version. This cross-sectional study was conducted using a convenient sampling of 560 people referred to comprehensive healthcare centers. The construct validity was assessed by exploratory (280 people) and confirmatory factor (with 280 people). The internal consistency was calculated using Cronbach's alpha coefficients. Based on the exploratory factor analysis, three factors of healthcare, disease prevention, and health promotion explained 48.9% of the total variance of health literacy. Cronbach's alpha was 0.96 for the whole instrument. The Persian version of the European Health Literacy Instrument (P-HLS-EU-Q47) had good validity and reliability, which can be used in future studies due to its good psychometric properties.