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Validating the Functional, Communicative, and Critical Health Literacy Scale Using Rasch Modeling and Confirmatory
Hanne Søberg Finbråten1,2, Øystein Guttersrud3, Gun Nordström4
1Inland Norway University of Applied Sciences, Elverum, Norway hanne.finbraten@inn.no hannesoeberg@hotmail.com.
Journal of Nursing Measurement
|December 21, 2018
Summary
A new 12-item version of the functional, communicative, and critical health literacy (FCCHL) scale shows improved reliability for assessing health literacy in type 2 diabetes patients. Multidimensional modeling confirmed its psychometric properties.
Area of Science:
- Health Sciences
- Psychometrics
- Chronic Disease Management
Background:
- The functional, communicative, and critical health literacy (FCCHL) scale is crucial for evaluating health literacy (HL) in individuals with chronic conditions like type 2 diabetes (T2DM).
- Current research often employs a consecutive modeling approach, treating the FCCHL subscales independently, which may not fully capture the scale's multidimensional nature.
Purpose of the Study:
- To investigate the psychometric characteristics of the FCCHL scale using multidimensional modeling approaches.
- To evaluate a refined, more parsimonious version of the FCCHL scale for assessing health literacy in T2DM patients.
Main Methods:
- Applied Rasch modeling and confirmatory factor analyses to data from 386 adults with T2DM.
- Utilized a six-point rating scale and a three-dimensional Rasch model to analyze the FCCHL scale's structure.
Main Results:
- A 12-item version of the FCCHL scale demonstrated reduced within-item bias.
- The refined 12-item scale exhibited improved subscale reliability indexes.
- The data best fit a three-dimensional Rasch model, supporting its multidimensional structure.
Conclusions:
- A parsimonious 12-item version of the FCCHL scale is suggested for use.
- The three-dimensional Rasch model provides the best fit for the FCCHL scale data.
- This refined scale offers a more robust assessment of health literacy in T2DM populations.
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