Validity and Reliability of the Indian Version of the HLS-EU-Q16 Questionnaire

Health literacy is a key topic in public health. Several measurement tools exist that operationalize health literacy, but only a few standard tools measure health literacy at a population level, and none of those are currently available for the Indian context. This study aimed to develop and validate an Indian version of the short form of the European Health literacy Questionnaire (HLS-EU Q16). Following the translation of the English version of the questionnaire in Hindi and Kannada by language experts and confirmation of the item content by health literacy experts, the questionnaire was administered to 158 Hindi speaking and 182 Kannada speaking individuals, selected via purposive sampling. Pearson's correlation was used to confirm test-retest reliability, and confirmatory factor analysis was used to assess the construct validity of the scales in both languages. Cronbach's alpha was calculated for the scales and their sub-domains, and item-total correlations were used to calculate item discriminant indices. Discriminant validity was examined by comparing scores of participant groups based on educational status and training in health care. Cronbach's alpha for the Hindi version of the tool (HLS-IND-HIN-Q16) was 0.98, and for Kannada version (HLS-IND-KAN-Q16) 0.97. Confirmatory factor analysis produced fit indices within acceptable limits. The results allowed us to conclude that the two Indian language questionnaires allow valid and reliable measurements of health literacy among the Hindi and Kannada speaking population of India.