Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-08-02 Cooperative journals: 《中国全科医学》
Abstract： Background Health literacy is closely associated with health status，most domestic studies tend to use multidimensional and multi-item tools for assessing health literacy，lacking simple and effective assessment methods. Objective To simplify health literacy scale and conduct psychometric test within the Chinese population. Methods Adults aged 18 years and above were selected from the "China Family Health Index Survey （2021）" for this investigation. Based on inclusion and exclusion criteria，a total of 7 449 participants were selected and randomly divided into two sample sets，including 3 680 cases in sample set 1 and 3 769 cases in sample set 2. The general information questionnaire，short-form health literacy questionnaire（HLS-SF12），perception social support scale（PSSS），and family health scale short-form（FHS-SF） were administered to the respondents. Classical test theory（CTT） and the Mokken model in item response theory（IRT） were used to screen the original items，and validation analyses such as reliability and validity of the simplified scales were also conducted. Results A 9-item version （HLS-SF9） and a 4-item version（HLS-SF4） were simplified by using CTT and the Mokken model，respectively. Both the HLS-SF9 and the HLS-SF4 had no ceiling effect or floor effect，and the Cronbach's α coefficients for both were 0.913 and 0.842，with split-half reliabilities of 0.871 and 0.815，respectively. The exploratory factor analysis of HLS-SF4 revealed one common factor，accounting for 67.813% of the cumulative variance，with factor loadings exceeding 0.81 for each item. The confirmatory factor analysis of HLS-SF9 showed that χ2 /df was 10.844，goodness of fit index（GFI） was 0.985，adjusted goodness of fit index（AGFI） was 0.971，normative fit index（NFI） was 0.986，comparative fit index（CFI） was 0.987，and root mean squared error of approximation （RMSEA） was 0.051. The correlation analysis demonstrated positive correlation of HLS-SF9 and HLS-SF4 with PSSS（r=0.367，0.292，P<0.001），as well as FHS-SF（r=0.340，0.237，P<0.001），respectively. The intraclass correlation coefficients（ICC）（95%CI） for the criterion validity of HLS-SF9 against HLS-SF12 was 0.989 （0.988，0.999），while for HLS-SF4 against HLS-SF12 was 0.892（0.886，0.899）. Conclusion The simplified health literacy scales have good reliability and validity，which are reliable and effective tools for assessing the health literacy of the Chinese population. Researchers can choose the scale according to the needs of research precision（HLS-SF9） or assessment time（HLS-SF4）.
Subjects: Psychology >> Psychological Measurement Subjects: Psychology >> Applied Psychology Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2022-12-06
Abstract：
Objective Simplify health literacy scales and conduct psychometric tests in Chinese cohorts. Methods A total of 7449 residents were included in the evaluation of the scale, and the data were randomly generated into 2 data sets for de Results A 9-item version of the scale (HLS-SF9) and a 4-item version of the scale (HLS-SF4) were simplified using CTT and the Mokken model, respectively.The Cronbach’s α coefficients of HLS-SF9 and HLS-SF4 were 0.913 and 0.842, HLS-SF4 was tested for one common factor by exploratory factor analysis(EFA), and the results of the confirmatory factor analysis(CFA) of HLS-SF9 showed that all the fitness indicators of its three-dimension model were excellent. And there was a significant positive correlation between the Perceived Social Support Scale and the Family Health Scale Short-Form as the calibration scale (r=0.367, p<0.001; r=0.292, p<0.001) (r=0.340, p<0.001; r=0.266, p<0.001), indicating good empirical validity. At the same time, HLS-SF9 and HLS-SF4 are highly consistent with the content measured by the original version of the scale. Conclusions The simplified Health Literacy Scales have good reliability and validity, and are reliable and effective tools for quickly assessing the health literacy of Chinese people.
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Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-11-23 Cooperative journals: 《中国全科医学》
Abstract：
This study outlines statistical methods and practical steps for the design and development of valid and reliable questionnaires within the primary health care domain. A series of studies on questionnaire development and scale design are reviewed and a standard process for scale design within the primary care domain is developed. The process addresses key practical steps in the scale design process as well as statistical methods, and is illustrated by examples from previous relevant studies within the field. We suggest the following seven-step approach to primary health care questionnaire development: (1) defining the conceptions to be measured; (2) generating the pool of items; (3) selecting the scoring system and response format; (4) pretesting (assessing content validity and face validity, etc.); (5) eliminating items by item analysis; (6) initial evaluation of the scale, including reliability evaluation of the scale, and factor analysis or Rasch analysis; (7) re-evaluation of the scale, which reexamines the nature of the scale, including retest reliability and construct validity. In general, scale design type of studies should strictly follow the standard steps of scale development, and the integrated use of Rasch model and factor analysis will make the results of measurement more objective.
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