The Reduced Multi-Dimensional Health Literacy Scale: A First Bilingual Validation Using RASCH Analysis.

Area of Science:

• Health Sciences
• Psychometrics
• Medical Sociology

Background:

• Health literacy is crucial for managing chronic conditions like type 2 diabetes.
• Assessing health literacy effectively requires reliable and valid measurement tools.
• Existing health literacy scales may be lengthy, prompting the need for shorter versions.

Purpose of the Study:

• To evaluate the psychometric properties of the reduced Ishikawa Health Literacy Scale (HLS).
• To assess the reliability and validity of German and Italian translations of the reduced HLS.
• To determine the suitability of the reduced HLS for use with individuals with type 2 diabetes.

Main Methods:

• A convenience sample of 100 individuals with type 2 diabetes participated.
• The nine-item reduced Health Literacy Scale (HLS) was administered.
• Rasch analysis was employed to evaluate item psychometrics, including person and item reliability, and item fit.

Main Results:

• Person and item reliability coefficients were good for both German (0.87) and Italian (0.72) versions.
• Correlation analyses indicated acceptable validity for both versions.
• Rasch analysis confirmed a generally good fit for the items, with no necessary modifications.
• Prevalence of high health literacy was 14% (German) and 10% (Italian), while low health literacy was 39% (German) and 56% (Italian).

Conclusions:

• The reduced HLS is a reliable and valid instrument for assessing health literacy in German and Italian populations with type 2 diabetes.
• Its brevity makes it suitable for integration into longer questionnaires or as a rapid screening tool.
• Further psychometric validation with larger, diverse samples is recommended.