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Published on: April 23, 2014
Development and validation of a functional health literacy test
Xu-Hao Zhang1, Julian Thumboo, Kok-Yong Fong
11 Department of Pharmacy, National University of Singapore, Singapore 2 Department of Rheumatology and Immunology, Singapore General Hospital, Singapore 3 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 4 Discipline of Pharmacy & Experimental Pharmacology, School of Biomedical Sciences, University of Newcastle, Callaghan, New South Wales, Australia.
A new 21-item functional health literacy test (FHLT) effectively screens general public and patient literacy. This reliable and valid tool supports health education programs and improves health outcomes.
Area of Science:
- Health Literacy Research
- Public Health Screening Tools
- Patient Education Assessment
Background:
- Existing functional health literacy tests (FHLTs) are not suitable for the general public.
- A need exists for a readily applicable FHLT for diverse populations.
Purpose of the Study:
- To develop and validate a functional health literacy test (FHLT) for the general public and healthcare patients.
- To establish the reliability and validity of the new FHLT.
Main Methods:
- Developed a 21-item FHLT using maze procedures, expert judgment, and interviews.
- Administered the FHLT to general public and rheumatic patients in Singapore.
- Assessed reliability using Cronbach's α and test-retest (ICC), and validity using correlations with REALM and education level.
Main Results:
- The FHLT demonstrated adequate reliability (Cronbach's α 0.68-0.72) and high test-retest reliability (ICC 0.95).
- Convergent validity was strong, correlating well with the REALM (0.65-0.68).
- Divergent validity was supported by weak correlations with education level (0.28-0.33).
Conclusions:
- The 21-item FHLT is a reliable and valid screening tool for functional health literacy in both the general public and patients.
- This FHLT can enhance health education effectiveness and improve health outcomes.
- The tool is applicable in general public settings and healthcare environments.
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