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Development of a cannabis health literacy questionnaire: preliminary validation using the Rasch model
Queen Jacques1, Jennifer Donnan2, Lisa Bishop2
1Division of Population Health and Applied Health Sciences, Faculty of Medicine, Memorial University of Newfoundland St. John's, St. John's, Newfoundland & Labrador, Canada. qrjacques@mun.ca.
BMC Public Health
|July 24, 2025
Summary
A new Cannabis Health Literacy Questionnaire (CHLQ) was developed and validated to measure knowledge and understanding of cannabis risks. This tool supports public health initiatives by assessing cannabis health literacy.
Area of Science:
- Public Health
- Health Literacy Measurement
- Cannabis Research
Background:
- Increasing cannabis integration in Canada necessitates public health awareness of associated risks.
- Lack of a validated tool hinders evaluation of cannabis health literacy initiatives.
Purpose of the Study:
- Develop and preliminarily validate the Cannabis Health Literacy Questionnaire (CHLQ).
- Measure individual knowledge, understanding, and utilization of cannabis health and safety information.
Main Methods:
- Framework based on existing health literacy domains and alcohol health literacy.
- Informed by literature, item-response theory, and stakeholder input.
- Four dimensions: cannabis knowledge, risk knowledge, risk understanding, information seeking/use.
- Refined through three iterations using Rasch analysis for reliability and validity.
Main Results:
- 1035 Canadian adults completed the CHLQ.
- All dimensions showed well-distributed item difficulties.
- High item separation (9.93–17.29) and reliability (0.99–1.00).
- Promising person separation (0.99–1.88) and reliability (0.49–0.78).
- Unidimensionality supported for all dimensions.
Conclusions:
- The CHLQ is a preliminary, multi-dimensional tool for measuring cannabis health literacy.
- Demonstrates promising psychometric properties for educational and research use.
- Provides a framework to inform public health efforts and future research.
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