A new Health Literacy Scale: Turkish Health Literacy Scale and its psychometric properties

Abstract

Health literacy (HL) is an important public health issue. It concerns the knowledge and competences of persons to meet the complex demands of health in modern society. It is also a key dimension of Health 2020, the European health policy framework adopted by Member States in 2012. The instrument labeled HLS-EU-Q is derived from the conceptual model and definition developed by the HLS-EU consortium. This study aims to develop a new Health Literacy Scale, Turkish Health Literacy Scale (THLS) and to evaluate its psychometric properties. THLS is a 32-item scale, adapted from the conceptual model and definition developed by the HLS-EU consortium. However, THLS takes into account of two relevant areas instead of three in HLS-EU. The two areas are 1) Health care, and 2) Disease prevention and health promotion. Four information processing stages (access, understand, appraise, apply) related to health relevant decision-making and tasks are also protected in the current scale. Psychometric properties were used to evaluate the reliability and validity of the instrument. The instrument demonstrated good internal consistency reliability with a Cronbach’s alpha of 0.927, where 0,880 and 0,863 for “health care” and “disease prevention and health promotion” areas, respectively. As for validity, six factors were extracted from 32 items, which together explained 54.8% of the instrument’s variance basing on confirmatory factor analysis. All items gave a factor load over 0,32 at the first factor. THLS has good reliability and validity, and it could be used to assess the overall health literacy. As a conclusion, due to the characteristics of the health care system in Turkey and an inadequate dissociation between applications of disease prevention and health promotion, a revision of the conceptual framework was needed. As a result of the revision, THLS became culture adaptive and would have an important function for the development efforts of the health literacy in Turkey. Additionally, easy application makes it an ideal tool for use in Turkey. Key messages THLS has good reliability and validity, and it could be used to assess the overall health literacy THLS is culture adaptive, easy to apply and an ideal tool for use in the Turkey