European health literacy survey questionnaire short form (HLS-Q12): adaptation and evidence of validity for the Brazilian context

Zanini, Daniela Sacramento; Peixoto, Evandro Morais; de Andrade, Josemberg Moura; Fernandes, Iorhana Almeida; da Silva, Maynara Priscila Pereira

doi:10.1186/s41155-023-00263-1

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Research • Psicol. Reflex. Crit. 36 • 2023 • https://doi.org/10.1186/s41155-023-00263-1 copy

European health literacy survey questionnaire short form (HLS-Q12): adaptation and evidence of validity for the Brazilian context

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Health literacy (HL) refers to knowledge, motivation and skills to understand, evaluate and apply health information, enabling appropriate decision making in daily life on health care and health promotion. Studies show that HL is associated with several social determinants, health outcomes, and health promotion. In Brazil, studies on the thematic are still scarce. Thus, the present study aimed to adapt, seek evidence of validity, reliability and estimate the parameters of the items of the European Health Literacy Survey Questionnaire Short Form (HLS-Q12) for the Brazilian context. 770 individuals participated, recruited through advertisements in the media and social networks, 82.1% female, aged between 18 and 83 (M = 35.5, SD = 13.52), from 21 Federative Units of Brazil and the Federal District. The subjects answered the HLS-Q12 and a sociodemographic questionnaire. Exploratory factor analysis indicated a unifactorial structure with good psychometric characteristics (GFI = 0.98; CFI = 0.98; RMSEA = 0.08; RMSR = 0.07). Cronbach's alpha, Guttman's lambda 2 and McDonald's omega reliability indicators were equal to 0.87. We conclude that the HLS-Q12 is an adequate instrument to assess the level of HL in the Brazilian population.

Keywords
Health literacy; Public health; Validity evidence; Item response theory

Item	Factor loading	h²
1. Find information on treatment of illnesses you have?	0.69	0.48
2. Understand what to do in medical emergencies?	0.71	0.51
3. Judge the advantages and disadvantages of different treatment options?	0.67	0.45
4. Follow the instructions on medication?	0.73	0.53
5. Find information on how to manage mental health problems like stress and depression?	0.70	0.49
6. Understand why you need health screenings?	0.76	0.58
7. Judge if the information on health risks in the media is reliable?	0.60	0.36
8. Decide how you can protect yourself from illnesses based on advice from family and friends?	0.40	0.16
9. Find information on health attitudes such as exercise, healthy food and nutrition?	0.76	0.57
10. Understand information on food packaging?	0.62	0.38
11. Judge which everyday behaviors are related to health?	0.78	0.61
12. Make decisions to improve your health?	0.59	0.34
Explained variance (%)	49.98%
Cronbach's alpha (α)	0.87
Guttman's Lambda 2 (λ)	0.87
McDonald's omega (ω)	0.87

Item	a	b₁	b₂	b₃
Item 01	1.72	-0.12	1.41	2.88
Item 02	1.81	-0.85	0.86	2.22
Item 03	1.63	-1.45	0.43	2.13
Item 04	2.01	0.38	1.67	2.62
Item 05	1.75	-0.32	0.97	2.31
Item 06	2.26	0.16	1.40	2.46
Item 07	1.31	-1.24	0.58	2.14
Item 08	0.76	-1.91	0.57	3.01
Item 09	2.12	0.18	1.53	2.85
Item 10	1.35	-0.31	1.08	2.32
Item 11	2.32	0.04	1.39	2.48
Item 12	1.27	-0.73	1.01	2.53

Curso de Pós-Graduação em Psicologia da Universidade Federal do Rio Grande do Sul Rua Ramiro Barcelos, 2600 - sala 110, 90035-003 Porto Alegre RS - Brazil, Tel.: +55 51 3308-5691 - Porto Alegre - RS - Brazil
E-mail: prc@springeropen.com

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[1] *Correspondence: Iorhana Almeida Fernandes iorhanafernandes@hotmail.com