Challenges in Navigating the Health Care System: Development of an Instrument Measuring Navigation Health Literacy

Area of Science:

• Health Services Research
• Public Health
• Health Literacy Studies

Background:

• Healthcare systems are increasingly complex, making it difficult for patients to navigate.
• Patients need specific skills, termed navigation health literacy (HL-NAV), to manage healthcare access and understanding.
• Existing measurement tools for HL-NAV are inadequate, limiting understanding of population-level capabilities.

Purpose of the Study:

• To develop and validate a new instrument, the HL-NAV-HLS19, for measuring navigation health literacy within the Health Literacy Population Survey 2019 (HLS19).
• To establish a reliable method for assessing patients' ability to access, understand, appraise, and apply information related to navigating healthcare.

Main Methods:

• A scoping literature review and development of a conceptual framework for HL-NAV.
• Item generation based on identified navigational tasks at system, organization, and interaction levels.
• Expert evaluations, stakeholder consultations, focus groups, pre-testing, and consortium feedback informed instrument refinement, resulting in twelve validated items.

Main Results:

• The HL-NAV-HLS19 instrument was successfully developed and comprises twelve feasible items.
• The instrument is ready for its initial deployment in the HLS19 survey to gather population-level data on HL-NAV.
• The developed instrument is suitable for cross-country comparisons, health system monitoring, and guiding intervention development.

Conclusions:

• The HL-NAV-HLS19 provides a novel and validated tool for measuring navigation health literacy in general populations.
• The HLS19 survey will yield the first large-scale data on HL-NAV, crucial for understanding patient navigation capabilities.
• Further validation and translation into multiple languages and countries are recommended to broaden the instrument's applicability.