The health competence measurement tool (HCMT): developing a new scale to measure self-rated "health competence"

To develop and test a tool for measuring health competence.

In order to measure this attribute, we used a sequential exploratory mixed methods design in rural and urban communities in Cameroon. In the qualitative phase, 67 clients constituted 10 focus groups to elicit themes related to health competence. In the quantitative phase, self-rated items were tested on 300 participants and on a random selection of 25 participants 2 weeks later.

The internal consistency for the subscales derived varied from 0.61-0.81. Older (F[45, 339.1]=1.2; p=0.031) and more educated (F[3, 22.6]=2.1; p=0.004) people were more likely to score higher on the scale. Interviewers also contributed to the variance (F[5, 37.6]=3.6; p<0.001). Test-retest reliability was 0.66. The final scale with 15 items is made up of three subscales: knowledge of disease, how to stay in good health and health information.

We present a new self-rated scale for health competence with good psychometric properties. It circumvents the need to be literate, but requires well trained interviewers. We recommend that it be tested in other settings.

This tool should be used to appraise individual and community health education needs with minor context specific modifications.