Development and validation of a novel instrument for evaluating sarcopenia health literacy in older adults
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Published on: May 31, 2021
Yu-Ang Chang1, Hsin-Yen Yen2, Nguyen Thanh Nhu3
1Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan; Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan.
Objective:
Effective management of sarcopenia relies on sustained lifestyle behaviors, which require adequate health literacy (HL). However, no disease-specific instrument is available to assess sarcopenia-specific HL. This study aims to develop the Sarcopenia Health Literacy scale (Sarco-HL) and conduct an initial evaluation of its psychometric properties among older adults.
Method:
A cross-sectional study was conducted among community-dwelling adults aged ≥ 60 years recruited from an outpatient clinic. The Sarco-HL scale was developed based on the European Health Literacy Survey (HLS-EU) framework and consisted of 24 items covering four health information-processing competencies (access, understand, appraise, apply) across three health domains (healthcare, disease prevention, health promotion). Reliability and validity were evaluated.
Result:
Among 91 participants (mean age 72 years; 66% women), the Sarco-HL demonstrated promising content validity (content validity index of 0.94), although elevated inter-item correlations suggested potential item redundancy. Construct validity evaluated through pre-specified hypothesis testing showed that Sarco-HL correlated with years of education (r = 0.51, p < 0.001), and with the Perceived Benefits subscale of the Exercise Benefits/Barriers Scale scores (EBBS-C) (r = 0.36, p = 0.001). Known-groups validity was supported as Sarco-HL scores differed by age groups (one-way ANOVA, p = 0.016), differences across age groups, and were lower in the sarcopenia spectrum group than in participants without sarcopenia (Welch's t, p = 0.004). Discriminant validity was supported by the near-zero, non-significant correlation between Sarco-HL and the Perceived Barriers subscale of the EBBS-C (r = 0.04).
Conclusion:
Our developed 24-item Sarco-HL scale demonstrated promising evidence of validity and reliability for sarcopenia-specific HL in older adults.
Practice Implication:
Our Sarco-HL scale provides a novel tool to be used clinically for at-risk individuals to identify HL gaps. Further structural validation is required before competency-specific scores or the instrument are applied to clinical practice.
