Evaluating short versions of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) for health checkups

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  • MAIE Azumi
    Center for Preventive Medicine, St. Luke’s International Hospital Affiliated Clinic
  • KANEKUNI Sachiyo
    Center for Preventive Medicine, St. Luke’s International Hospital Affiliated Clinic
  • YONEKURA Yuki
    Graduate School of Nursing Science, St. Luke’s International University
  • NAKAYAMA Kazuhiro
    Graduate School of Nursing Science, St. Luke’s International University
  • SAKAI Rieko
    Center for Preventive Medicine, St. Luke’s International Hospital Affiliated Clinic Department of Preventive Health Care for Women, Aiiku Hospital, Maternal and Child Health Center

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Abstract

<p>Objective: The benefit of health literacy (HL) on adopting a healthy lifestyle is well established and enhancing HL as part of regular health checkups contributes to the prevention of lifestyle-related diseases. Tuned health advices requires preliminary assessment of HL. To balance evaluation precision and cumbersomeness, we aimed to find the most parsimonious questionnaire for our checkups.</p><p>Methods: Participants (n = 714 with 55% female, 51.2 ± 10.9 years old) were recruited among the examinees who visited our checkups, and a cross-sectional survey was conducted by using the Japanese version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47). Three short versions of HLS-EU-Q47 (HLS-Q12, HL-SF12, and HLS-EU-Q16), were explored using confirmatory factor analysis (CFA) to assess dimensionality and factorial validity together with Rasch analysis (RA) to provide detailed information at the item level.</p><p>Results: Using likelihood-ratio tests, we found that all three short versions were better fit under a three-dimensional Rasch model (health care, disease prevention and health promotion) than one-dimensional one. All of them were above threshold for person separation reliability (PSR > 0.65), with only moderate loss of separation compared to HLS-EU-Q47. CFA supported the factor structure of the three domains, and HLS-Q12 has the best goodness-of-fit indices.</p><p>Conclusions: Among the parsimonious questionnaire that we compared, HLS-Q12 is the best candidate, meeting the assumptions and the requirements of objective measurement while offering clinically feasible screening during regular checkups. In the next phase, we will evaluate the benefit of using individual's HL to tune life-style improvement advice.</p>

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