Network Analysis of the HLS₁₉-Q12 Health Literacy Questionnaire: insights from an Italian Pilot Study

Area of Science:

• Health Communication
• Public Health
• Digital Health

Background:

• The internet and social media significantly influence health information access and health literacy.
• Health literacy is vital for promoting and maintaining individual and community health.
• Existing conceptual models of health literacy require validation with modern data analysis techniques.

Purpose of the Study:

• To analyze the correlation and distribution of items from the Health Literacy Survey Questionnaire (HLS-Q) 12 short form using network analysis.
• To verify the correspondence of HLS-Q items to the principal domains of the 2013 Sorensen et al. health literacy conceptual model.
• To explore the structure of health literacy in the digital age.

Main Methods:

• A digital version of the Italian HLS19-Q12 questionnaire was administered online to 352 participants in Cagliari, Italy.
• Network analysis, specifically the Ising Fit method via JASP, was employed to examine item clustering and relationships.
• Data collection occurred in May 2024 via social media and informal online channels.

Main Results:

• Network analysis revealed significant challenges in accessing professional health help and understanding medical emergencies.
• Centrality measures identified items related to medical emergencies and health decision-making as particularly prominent.
• Three interconnected clusters emerged: healthcare, disease prevention, and health promotion, with some items shifting domains.

Conclusions:

• Network analysis illustrates health literacy as an interactive system, emphasizing information access, evaluation, and application.
• Empowerment emerged as a critical factor in health literacy, according to the study's findings.
• Targeted interventions focusing on identified needs and prominent items can enhance health literacy and improve health outcomes.