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Related Experiment Video

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Qualitative and Quantitative Validation of Tools with Rating Scales Aimed at Assessing the Quality of University Service-Learning
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Structural Validation and Measurement Invariance of the HLS-Q12 Health Literacy Instrument in Finnish Adults:

Jing Zhou1,2, Hanna Rekola2,3, Marjorita Sormunen4

  • 1School of Law, Shanghai Lixin University of Accounting and Finance, Shanghai, China.

International Journal of Public Health
|April 13, 2026
PubMed
Summary

The Finnish Health Literacy Questionnaire (HLS-Q12) demonstrates good reliability and measurement invariance across Finnish adult sociodemographic groups, supporting its use for population health monitoring.

Keywords:
HLS-Q12alignment methodhealth literacymeasurement invariancestructural validation

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Area of Science:

  • Health Literacy Research
  • Psychometrics
  • Sociodemography

Background:

  • Health literacy is crucial for population health.
  • Assessing health literacy requires validated instruments.
  • The HLS-Q12 is a widely used measure.

Purpose of the Study:

  • To evaluate the internal structure, consistency, and measurement invariance of the Finnish HLS-Q12.
  • To examine HLS-Q12 performance across sociodemographic subgroups in Finland.
  • To validate the HLS-Q12 for population health monitoring.

Main Methods:

  • Utilized data from 7,077 Finnish adults.
  • Employed multi-group confirmatory factor analysis (MGCFA) and alignment optimization.
  • Assessed invariance across gender, age, education, and study samples.

Main Results:

  • High reliability (Cronbach's alpha = 0.905, McDonald's omega = 0.896) and good fit for a unidimensional structure.
  • Scalar invariance supported for gender, education, and study samples via MGCFA.
  • Alignment optimization indicated acceptable non-invariance, with higher health literacy in women and highly educated individuals.

Conclusions:

  • The Finnish HLS-Q12 is suitable for subgroup comparisons and population health monitoring.
  • Measurement invariance is largely adequate across key sociodemographic groups.
  • Further research should explore external validity using external criteria.