Literacy Measurement Tools Research Articles

재난 리터러시 관점에서의 코로나19 관련 정례브리핑에 대한 비판적 분석

The purpose of this study is to establish the concept of disaster literacy and to lay the foundation for the formation of disaster literacy discourse by presenting constituent factors. And from the perspective defined in this way, I tried to critically review the text structure and language usage patterns of the regular briefing related to COVID-19 by the Central Disease Control Headquarters. Ultimately, this study attempted to find ways to improve the use of disaster language that fostered disaster literacy capabilities in public areas. This study first defined disaster literacy based on previous studies and clarified the factors constituting disaster literacy to prepare a literacy measurement tool. Through this, this study emphasized that in the case of disaster literacy, the stages of disaster development are diverse, and the contents of the required literacy should be changed according to the phase of the disaster. In this paper, disaster literacy was defined in this way in three dimensions, and based on that point of view, text analysis was conducted on 190 regular briefings related to COVID-19 by the Central Disease Control Headquarters. Through this, this study attempted to examine the structural aspects of the texts, examine the characteristics of the language used in each structure, and derive improvements.

Evaluation of a New Performance-Based Health Literacy Measurement Tool for Individuals With Chronic Airways Disease.

Low health literacy is a global challenge. Health literacy is positively correlated with chronic airways disease desirable outcomes. Despite the importance of health literacy in disease management, current health literacy measurement tools are suboptimal. As part of a multi-stage project to develop a performance-based, disease-specific Vancouver Airways Health Literacy Tool (VAHLT) for individuals with chronic airways disease, this study assessed the relationships between the VAHLT scores and characteristics of patients with chronic airways disease. The primary aim of the study was to provide preliminary evidence of construct validity of the VAHLT. A cross-sectional study design was applied. Study subjects were recruited from 6 specialty care clinics to complete the VAHLT measurement tool. Demographic and clinical data, including quality of life and disease control, were collected via validated questionnaires. The study subjects also completed a spirometry test. Inferential analysis was conducted by using mean difference testing and correlational methods. A total of 320 subjects were recruited, and, after imputing missing data, 315 were ultimately analyzed. The subjects were predominantly women (61%), white (83%), had a post-high-school education (74%), and a mean ± SD age of 65.2 ± 13.2 y. Age was significantly negatively correlated with the VAHLT scores (P = .004); the subjects with a post-high school education had significantly higher VAHLT scores than those with a high school education or less (P < .001). No significant sex or ethnicity related differences in VAHLT scores were observed. For clinical outcomes, no significant differences were found between the VAHLT scores and disease severity or measures of quality of life and asthma control. We report a chronic airways disease-specific health literacy measurement tool developed with the involvement of patients and professionals. Age and education were highly correlated with health literacy, which emphasizes the importance of addressing these factors in health literacy interventions among patients with chronic airways disease.

DIGITAL TECHNOLOGY USE IN TURKEY AND THE NEED FOR NEW eHEALTH LITERACY MEASUREMENT TOOLS

Aim of the study: Digital health technologies, which cause the reshaping of today's patient-health relationship have been reflected in every field of health services. In a setting where the patient-health relationship is so dependent on the use of digital tools and the internet, it has become one of the most important elements for the development of their health for users to have the necessary digital skills and eliminate false and unnecessary information and data and acquire their health needs. Thus measuring the digital health literacy of consumers became a necessity. The aim of this study is to clarify the need for developing or adopting new digital health literacy measurement tools in Turkey. &#x0D; Materials and Methods: For the purpose to reveal the state of digital health literacy in Turkey the reports announced by different international and national institutes were searched in this descriptive research. The prevalence of the use of social media, the increase in the number of internet users and mobile devices in recent years, individuals’ reasons for using the internet, and the ratio of searching health issues in this data were compiled. Additionally, the digital/eHealth literacy scales developed or adopted in Turkish by researchers were searched from databases.&#x0D; Results: The results showed that the adaptation of Turkey and its people to e-health is very high and Turkish people take the lead the way in terms of accessing health-related information, integrating with the health system, and using health-related applications. So the need for digital health literacy scales and their potential use in Turkey was reported in this study. According to the results of the study only one measurement tool, developed by Norman and Skinner (2006) was adopted in Turkish and used by Turkish researchers. This study mostly used ten digital/eHealth literacy instruments were introduced and the gap in this area was argued. Although there are many digital/eHealth literacy scales adopted in various countries, in Turkey researchers stay behind in that situation. The need for developing or adopting new digital/eHealth literacy scales is obvious.

5.K. Workshop: National and European studies on health literacy in children and adolescents

Abstract Health literacy describes how people use health information to make informed decisions in context of healthcare, disease prevention and health promotion. Enhancing health literacy of populations is critical and in particular important at an early age, which is understood to be more sustainable because health literacy contributes to improved personal health and development. Low health literacy in child and adolescent populations has been linked to worse health outcomes and health disparities in Europe, making health literacy of children and adolescents an important public health topic. Developing and delivering target group specific interventions and services requires precise data generation on the state of health literacy in early age. In the past decade, several conceptual approaches have been undertaken but methodological sound, validated and reliable measurement tools are still scarce. Available systematic reviews show that most tools originated from North America and/or English speaking countries. However, in the past years European researchers have been involved with research on health literacy in childhood and adolescence, the result of which culminated into heavy progress regarding the development of health literacy measurement instruments, including generic health literacy, digital health and mental health literacy. These new developments lead to the availability of validated tools for school-aged children, including primary and secondary school children. The purpose of this workshop is to bring together five contemporary health literacy studies conducted in child and adolescent populations across Europe, including national and European-wide studies. Both methodological findings regarding the measurement tool and empirical data will be introduced. The first presentation emerges from the HLCA HL-Kids project, which has been conducted in Germany and focusses on primary schoolchildren, using the HLS-Child-Q15 tool. The second presentation originates from the Netherlands where the HLS-Child-Q15 tool was adapted to Dutch children. The third presentation aims at health literacy of adolescents in secondary school-age in Germany, by using the MOHLAA-Q tool. The fourth presentation originates from the WHO-led HBSC study, which has been conducted by using the HLSAC questionnaire. The final presentation will focus on the first digital health literacy measurement tool for secondary schoolchildren, which has been developed within a German study in schools. Each project will be given ten minutes to present their findings, including questions, which will be followed by Q&amp;A and an open discussion with the audiences. This workshop offers a forum for researchers, practitioners and policy-makers interested in health literacy measurement in children and adolescents. By dialogue and two-way communication, vivid interaction will be ensured, allow building synergies, and facilitate networking and capacity building. Key messages • Health literacy contributes to improved personal health and development of children and adolescents. • The measurement of health literacy is key to public health intervention success and needs theory driven, validated and reliable instruments.

A systematic review of the effectiveness of community interventions to improve parent health literacy

Abstract Background Many community-based interventions have been developed to increase parent/caregiver health literacy, yet no systematic review of their effectiveness has been published. Therefore, the aim of this systematic review was to examine the effectiveness of community-based health literacy interventions in improving the health literacy of parents/caregivers. Methods A systematic review of six databases; MEDLINE, PsycINFO, CINAHL, Cochrane Library, Embase, and Education Source were conducted to identify relevant articles. Risk of bias were assessed using version two of the Cochrane risk of bias tool for randomised controlled trials or the Cochrane Collaboration Risk of Bias in Non-Randomised Studies of Interventions. The study findings were grouped and synthesised following the Synthesis Without Meta-analysis framework. Results Eleven community-based health literacy interventions for parents/caregivers were identified. Study design included randomised controlled trials (n = 4), non-randomised studies with comparison group (n = 4), and non-randomised studies without a comparison group (n = 3). Interventions were delivered digitally, in person or a combination of the two. The main findings of the studies showed some potential for both in person and digital interventions to increase parental health literacy. The risk of bias was high in over half the studies (n = 7) Studies were heterogeneous preventing a meta-analysis. Discussion Although no definitive conclusion of the effectiveness of community-based interventions can be drawn there are suggestions of improvement in many of the studies included in this review. The review has brought into question whether the health literacy measurement tools used met the needs of assessing the interventions outcomes. When comparing the cost and resources needed for digital with in person interventions, the findings of this review have implications for both practise and research. Key messages

우리나라 헬스리터러시 측정 도구의 연구 동향 분석: 주제범위 문헌고찰(Scoping review)

Objectives: This study aims to provide a descriptive review of the published health literacy measurement tools developed and validated in South Korea. Methods: Using Scoping Review methods, a literature review was conducted by scanning international and Korean databases (PubMed, CINAHL, Scopus, RISS, SCIENCEON, KoreaMed). Among the 181 articles explored, 26 were included in the review. Results: Of the 26 articles (27 tools) reviewed, 17 measured general health literacy, while nine were content/context specific. Among the 17 general health literacy measures, 12 tools were translated (from REALM, NVS, Chew, HLS-EU, and HL-SDHQ) and five were newly developed in the Korean context. Except for the REALM-family measures, all the general health literacy instruments apply multi-dimensional characteristics. Most health literacy measures had acceptable reliability (α=.70) and reported a diverse validation process (81% of the 26 articles). Conclusion: Newly developed health literacy measures need to be validated in a cultural and language-specific context. Future health literacy measures should focus on specific information concerning health literacy measures, such as time for evaluating literacy status, representative sampling for testing, and understudied populations, such as young individuals. Future systematic reviews should be conducted with further rigorous quality assessment of the health literacy instruments in Korea.

EHealth literacy measurement tools: a systematic review protocol

BackgroundImproving eHealth literacy (eHL) is one of the biggest challenges currently facing the global healthcare community. Indeed the use of digital services has the potential to engage patients in care as well as improve the effectiveness of chronic disease self-management, it remains highly dependent on a patient’s specific skills and experiences in the health care systems. Although eHealth literacy has gained momentum in the past decade, it remains an underresearched area, particularly eHealth literacy measurement. The aim of the review is to identify patient-reported outcome measures (PROMs) of eHealth literacy for adult populations and to summarize the evidence on their psychometric properties.MethodsWe will conduct a systematic literature review of the tools used to measure eHealth literacy for adult population. The search strategy aims to find published studies. A three-step search strategy will be used in this review. Published studies will be searched in CINAHL, PubMed, PsycINFO, and Web of Science from inception until end. Grey literature will be searched to find theses. Database search strategies will be formulated and tested with the assistance of an expert Health Sciences Librarian. The selection of studies will be done by two independent reviewers. Disagreements will be resolved through consensus, and a third reviewer will solve discrepancies. Furthermore, two reviewers will independently evaluate the methodological rigor of the instruments development and testing and assign a grade using the standardized Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Disagreements will be discussed with a third reviewer, expert in psychometrics.Extracted data will be aggregated and analyzed to produce a set of synthesized findings that will be used to develop evidence-informed recommendations in regard of eHL instruments. We will present a synthesis of all instruments, their psychometric properties, and make recommendations for eHL instrument selection in practice. Reporting will be informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and a PRISMA flow diagram.DiscussionThis systematic review will summarize the evidence on the psychometric properties of PROMs instruments used to measure eHL and will help clinicians, managers, and policy-makers to select an appropriate instrument.Systematic review registrationPROSPERO CRD42021232765

Development and validation of a novel short-form nutrition literacy measurement tool for Chinese college students.

ObjectivesTo develop and validate a short-form nutrition literacy (NL) assessment tool for Chinese college students based on a 43-item NL measurement scale.MethodsTo develop and validate short-form NL scale, 1359 college students were surveyed, the data were analyzed using exploratory factor analysis, linear regression analysis, Item analysis, confirmatory factor analysis, and Pearson correlation.ResultsThe 12-item short-form NL scale (NL-SF12) was developed using factor analysis and regression analysis, which accounted for 96.4% of the variance. The correlation coefficient between the NL-SF12 and NL-43 was 0.969, indicating satisfactory criterion-related validity. The NL-SF12 had a Cronbach's α of 0.890, suggesting strong internal consistency reliability, and content validity index was greater than 0.9, indicating that each domain accurately reflects the connotation of nutrition literacy. The model–data fit and convergent validity of the confirmatory factor analysis results were both good.ConclusionThe NL-SF12 is an effective measurement tool with a good reliability and acceptable validity to assess comprehensively NL for college students, and is applicable to quick, widespread use in population study and practice with low respondent burden.

Development of Digital Health Literacy Instruments for Students of the Faculty of Health Science, Universitas Dian Nuswantoro

Background and Objective: In the health sector, students' ability to filter incoming information and make sound decisions is critical. The purpose of this research is to create a digital health literacy measurement tool for health students.&#x0D; Methods: This research is a study of developing a digital health literacy measurement tool for health faculty students whose validity and reliability have been tested. Online questionnaires were distributed to 337 active students. The questionnaire went through several stages of development, including literature review, expert review, trial and field test. &#x0D; Results: The questionnaires related to digital competence and health literacy were used to conduct the literature review. Following various reviews, the main references for this research are "Digital competency framework for citizens-DigComp 2.1" and "Health literacy scale." According to the expert's opinion, the invalid (unimportant) questions were "I can distinguish appropriate and inappropriate digital content to share on social media so that my privacy and that of others are not jeopardized." and "I know how to find useful health information on the internet." Questions were removed in order to be distributed to trials. According to the test results, all questions meet the validity assumption. The Pilot Test results were tested on 337 respondents during the field test stage to ensure that all valid questions and question items were accepted.&#x0D; Discussion: This study found 24 good questions to measure digital health literacy based on nine indicators, namely: Access to Health Information (2 questions), health information management (2 question), integration of health information (2 questions), and evaluation of health information (2 questions), information and data literacy (2 question), communication (1 question), collaboration (2 question), digital content creation (2 question), safety (4 questions), and problem-solving (5 questions).

Nutrition Literacy Measurement Tool With Multiple Features for Chinese Adults.

Nutrition literacy is an emerging term which is increasingly used in policy and research. Progression is limited by the lack of an accepted method to measure nutrition literacy in Chinese adults, even as research in this area is growing. The objective of this study is to develop a valid instrument to assess nutrition literacy in Chinese adults. The process involved 2 steps: constructed nutrition literacy conceptual framework, and developed potential items of scale based on literature review; and conducted 2 rounds of Delphi consultation to select items of the preliminary questionnaire. In the Delphi survey, the content validity index for each domain, level, and dimension of nutrition literacy was 1.0, coefficient of variation was less than 0.10, and Kendall's coefficient of concordance was greater than 0.83. All of the 2 domains, 3 levels, and 6 dimensions initially formulated by our research team were reserved in the conceptual framework of nutrition literacy. Furthermore, a 43-item nutrition literacy measurement scale was established. Each item kept in the final scale reaches a high degree of concentration and a high degree of coordination, with the mean of importance ranging from 4.38 to 5.00. A nutrition literacy measurement scale with multiple features was established for Chinese adults, providing an operationalized tool to assess comprehensively nutrition literacy for research and practice in the field of nutrition, diet, and health.

POSA373 Evaluation of Ehealth Literacy Measurement Tools and Its Associated Factors: A Systematic Review and Meta-Analysis

As the use of eHealth is growing, accessibility of the internet and competency of the users in understanding the acquired information has been widely studied. Numerous instruments for measuring eHealth literacy (eHL), i.e., the ability to find, appraise, and use electronic health information, have been developed, but few studies have evaluated the existing eHL tools. Therefore this study aimed to identify and appraise the validated tools for measuring eHL and explore the associated factors.

Higher food literacy scores are associated with healthier diet quality in children and adolescents: the development and validation of a two-dimensional food literacy measurement tool for children and adolescents.

BACKGROUND/OBJECTIVESMost child and adolescent food literacy measurement tools focus on nutrition and food safety. However, the importance of aspects related to the food system such as food distribution and food waste and their effects on environmental sustainability is growing. We therefore developed and validated a two-dimensional tool for children (8–12 years old) and adolescents (13–18 years old) that can comprehensively measure food literacy. The association of food literacy with diet quality and self-reported health was assessed.SUBJECTS/METHODSFirst, we developed a food literacy conceptual framework that contains food system and literacy dimensions through a literature review, focus group interviews, and expert review. After a face validity study, we conducted the main survey (n = 200) to validate the questionnaire. Construct validity and reliability were assessed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach's alpha.RESULTSAs a result of the Delphi study, content validity was confirmed for the remaining 30 items after two items were excluded (content validity ratio = 0.86). Eleven items were excluded from the EFA results, while the CFA results indicated appropriate fit indices for the proposed model (comparative fit index = 0.904, root mean square error of approximation = 0.068). The final food literacy questionnaire consisted of 19 questions and comprised 5 factors: production, distribution, selection, preparation and cooking, and intake. Food literacy was positively associated with diet quality, as assessed by the Nutrition Quotient score, in both children and adolescents and with self-reported health in adolescents.CONCLUSIONSBased on this integrated conceptual framework, a two-dimensional 19-item food literacy measurement tool was developed and verified for practical use to improve the diet quality and food-related environmental sustainability awareness of children and adolescents.

Health literacy in cancer caregivers: a systematic review.

Cancer caregivers play a vital role in the care and health decision-making of cancer survivors. Consequently, their health literacy levels may be particularly important, as low levels may impede adequate care provision. As such, the current review aimed to systematically examine the literature on health literacy amongst cancer caregivers. We systematically searched the following databases using controlled vocabulary and free-text terms: PsychINFO, MEDLINE, EMBASE, CINAHL and Web of Science. Peer-reviewed empirical studies that explicitly measured and reported cancer caregiver health literacy levels were included. The search yielded six articles consisting of 593 cancer caregivers exploring health literacy and eHealth literacy. There was substantial variation in health literacy measurement tools used across included studies, precluding the possibility of conducting a meta-analysis. The included articles reported significant associations (limited to single studies) between caregiver health/eHealth literacy and (i) cancer survivor demographics, (ii) caregivers' communication style, (iii) caregiver Internet access and (iv) caregiver coping strategies. Findings highlight a need for future longitudinal research regarding cancer caregiver health literacy incorporating more standardized and population-specific measurement approaches. In particular, there is a pressing need to investigate factors associated with cancer caregiver health literacy to inform the development/delivery of future interventions. Future high-quality research which investigates the factors which contribute towards sub-optimal health literacy amongst cancer caregivers would aid in the development of appropriate and effective health literacy interventions in these groups. Such interventions would allow this important group to provide appropriate support to cancer survivors and enhance survivors' engagement in their health and wellbeing.

Development of a tool for food literacy assessment for young adults: Findings from a Korean validation study.

There is little research on the development and validation of measurement tools to evaluate integrative concepts of food literacy; however, this is a growing research area. A food literacy measurement tool for young Korean adults was developed in three phases: (1) tool development and content validation using the Delphi method (2) pilot testing (n=108) and (3) confirmatory study (n=435) and internal consistency using Cronbach's α and the test-retest for reliability. p<0.05 was considered statistically significant. Feedback from the Delphi rounds resulted in modification and rewording of nine items, yielding 105 items with acceptable content validity ratio (CVR). Exploratory factor analysis (EFA) revealed an eight-factor construct: food and nutrition knowledge, food safety, food systems, sociocultural context, food skill, food choice, self-efficacy, and food resource management. Confirmatory factor analysis (CFA) indicated that the validated tool met the acceptable indices of basic psychometric standards, and internal consistency was satisfactory for all subscales (Cronbach's α >0.70). A validated food literacy assessment tool for young Korean adults was developed.

Development and statistical assessment of a radiation safety literacy measurement tool

Development and statistical assessment of a radiation safety literacy measurement tool

EHealth Delivery of Educational Content Using Selected Visual Methods to Improve Health Literacy on Lifestyle-Related Diseases: Literature Review.

BackgroundLifestyle-related diseases, such as stroke, heart disease, and diabetes, are examples of noncommunicable diseases. Noncommunicable diseases are now the leading cause of death in the world, and their major causes are lifestyle related. The number of eHealth interventions is increasing, which is expected to improve individuals’ health literacy on lifestyle-related diseases.ObjectiveThis literature review aims to identify existing literature published in the past decade on eHealth interventions aimed at improving health literacy on lifestyle-related diseases among the general population using selected visual methods, such as educational videos, films, and movies.MethodsA systematic literature search of the PubMed database was conducted in April 2019 for papers written in English and published from April 2, 2009, through April 2, 2019. A total of 538 papers were identified and screened in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. Finally, 23 papers were included in this review.ResultsThe 23 papers were characterized according to study characteristics (author and year of publication, study design and region where the study was conducted, study objective, service platform, target disease and participant age, research period, outcomes, and research method); the playback time of the educational videos, films, and movies; and the evaluation of the study’s impacts on health literacy. A total of 7 studies compared results using statistical methods. Of these, 5 studies reported significant positive effects of the intervention on health literacy and health-related measures (eg, physical activity, body weight). Although most of the studies included educational content aimed at improving health literacy, only 7 studies measured health literacy. In addition, only 5 studies assessed literacy using health literacy measurement tools.ConclusionsThis review found that the provision of educational content was satisfactory in most eHealth studies using selected visual methods, such as videos, films, and movies. These findings suggest that eHealth interventions influence people’s health behaviors and that the need for this intervention is expected to increase. Despite the need to develop eHealth interventions, standardized measurement tools to evaluate health literacy are lacking. Further research is required to clarify acceptable health literacy measurements.

Translation, cultural adaptation and psychometric properties of the Ghanaian language (Akan; Asante Twi) version of the Health Literacy Questionnaire

BackgroundPatients’ competencies and resources to manage their own health, which is termed health literacy, is a necessity for better health outcomes. Thus, it is relevant to have a comprehensive health literacy measurement tool suitable for populations of interest. The Health Literacy Questionnaire (HLQ) is a tool useful for health literacy assessment covering nine dimensions/scales of health literacy. The HLQ has been translated and validated in diverse contexts but has so far not been assessed in any country in sub-Saharan Africa. We sought to translate this tool into the most common language used in Ghana and assess its validity.MethodsWe carried out a cross-sectional study using the HLQ concurrently with an assessment of a malaria programme for caregivers with children under 5 years. The HLQ was translated using a systematic translation procedure. We analysed the psychometric properties of the HLQ based on data collected by face-to-face interview of 1234 caregivers. The analysis covered tests on difficulty level of scales, composite reliability, Cronbach’s alpha and confirmatory factor analysis (CFA).ResultsCognitive testing showed that some words were ambiguous, which led to minor rewording of the questionnaire. A nine-factor CFA model was fitted to the 44 question items with no cross-loadings or correlated residuals allowed. Given the very restricted nature of the model, the fit was quite satisfactory: χ2 DWLS (866 df) = 17,177.58, p < 0.000, CFI = 0.971, TLI = 0.969, RMSEA = 0.126 and SRMR = 0.107. Composite reliability and Cronbach’s alpha were > 0.65 for all scales except Cronbach’s alpha for scale 9, ‘Understanding health information well enough to know what to do’ (0.57). The mean differences between most demographic groups among health literacy scales were statistically significant.ConclusionThe Akan-Twi version of HLQ proved relevant in our description of the health literacy levels among the caregivers in our study. This validated tool will be useful to conduct health literacy needs assessments to guide policies addressing such needs. Further work is needed to validate this tool for use in Ghana and similar contexts.

Development of a Comprehensive Food Literacy Measurement Tool Integrating the Food System and Sustainability.

The concept of food literacy is evolving and expanding, increasing the need for a comprehensive measurement tool for food literacy. This study aimed to develop a validated food literacy questionnaire based on an expanded conceptual framework for food literacy. A literature review of existing frameworks and questionnaires for food literacy and focus group interviews (n = 12) were conducted to develop a conceptual framework and candidate questions. A Delphi study (n = 15) and pilot survey (n = 10) to test the preliminary questionnaire’s content and face validity were conducted, which were followed by the main survey (n = 200). Construct validity and reliability were assessed using exploratory factor analysis (EFA) and Cronbach’s alpha, respectively. Criterion validity was assessed by comparing food literacy scores with food knowledge scores (FN-score) and nutrient quotient scores (NQ-score). By integrating and revising the six existing conceptual frameworks and focus group interview results, we proposed a two-dimensional conceptual framework comprising a literacy dimension and a food system dimension. After reviewing 560 items and categorizing them into 18 domains (3 in the literacy dimension × 6 in the food system dimension), 32 questions were selected. As a result of the Delphi study, two items were deleted, and content validity was confirmed for the remaining 30 items (content validity ratio (CVR) = 0.92). Ten items were revised during the face validation process, and five items were excluded as a result of the EFA. The final food literacy questionnaire comprised 25 questions related to five factors: production, selection, preparation and cooking, intake, and disposal. Food literacy scores were positively associated with FN- and NQ-scores, confirming the reliability and criterion validity of the final questionnaire. The two-dimensional food literacy conceptual framework developed in this study systematically encompasses complex food literacy concepts by adding a food systems dimension (production, selection, preparation and cooking, intake, and disposal domain) to the existing literacy dimension (functional, interactive, and critical literacy domain). Based on this integrated conceptual framework, a 25-item food literacy questionnaire was developed and validated for practical use.

Health Literacy Measurement Tool for Patients with Type 2 Diabetes Mellitus in Thailand

Background: The health literacy (HL) measurement tools have been various and not yet standardized.Objectives: To investigates the properties of HL measurement tool for patients with type 2 diabetes mellitus(T2DM).Methods: A cross-sectional study was conducted among 620 T2DM. Participants were interviewed aboutthe 62 health literacy items in three domains: (a) reading medical terms; (b) numeracy test; and (c) decisionmaking. The data were collected from January to April 2019. The reliability, discrimination, and difficultyare examined using the Kuder-Richardson Reliability Coefficient (KR-20), indices of discrimination anddifficulty.Results: The study found 49.8% aged older than 60 years, 80.2% had primary education level and 72.4%received no insulin injections. The properties of the HL measurement tool were (1) the reliability is excellentlevel for medical terms (KR-20 = 0.98) and good levels for both numeracy test and decision making (KR-20= 0.72 and 0.79, respectively); (2) The index of discrimination are high for both medical terms and decisionmaking (r = 0.58 – 0.80 and 0.48-0.55, respectively) but low level for the numeracy test (r = 0.02 – 0.43);(3) The indices of difficulty are high level for medical terms and decision making (p = 0.45 – 0.70 and 0.73– 0.76, respectively) but low level for numeracy test (p=0.02 – 0.64).Conclusions: The 62-item tool is considerably good to measure HL for patients with type 2 diabetes regardingits reliability, discrimination, and difficulty. However, the numeracy test should be more developed to thediscrimination and difficulty.

Evolution of Health literacy measurement tools

Abstract Introduction This study aimed to provide a review of the tool characteristics and dimensions of health literacy measurement tools. Indeed, it is crucial to establish a clear correlation between what the tools detect and the definition of health literacy. The research question is therefore to what extent health literacy measurement tools are able to detect the ability and levels to make judgment and take decisions in everyday life concerning health. Methods A systematic review was conducted. PubMed, EMBASE, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials were searched using MeSH, EMTREE terms, keywords, and keyword phrases on Health literacy tools and instruments from 1990 through 2020. An environmental scan was conducted to identify other health literacy measurement tools. For each tool, researchers evaluated validation, items and conceptual dimensions, and psychometric properties. Results 198 tools were identified, 96 measured general health literacy, 38 measuring comprehension, the others were aimed to assess health literacy for specific diseases or populations. Most tools are performance-based, require in-person administration, and are exclusively available in a pencil and paper testing mode. Reported administration times vary, from less than 1 to 30 minutes. Validation procedures for most of the tools are limited by inadequate power to ensure reliability across subgroups. Conclusions The health literacy measurement tools currently available represent a narrow set of conceptual dimensions with limited modes of administration. Most of the tools are lacking key psychometric properties. Significant work is needed to establish important aspects of the construct, convergent, and predictive validity for many tools. Furthermore, from a more practical point of view doubts emerged about the actual suitability of these tools in the day to day health care/promotion settings. Work is needed to develop more rapid and straightforward tools for practice. Key messages Measure health literacy save lives. Health literacy is a vital sign.