Validating the HLS-EU-Q47 for the Indian context
(2019) 4th European Health Literacy Conference — Location: Dublin (14.March.2019)
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- Background/Objectives Health literacy is increasingly recognized as a key concept for public health. Poor health literacy is closely associated with an improper management of health, suboptimal uptake of preventive and health care services, unhealthy behaviour, increased likelihood for chronic conditions and medical complications, and increased health care costs. In India, studies using the REALM, STOFHL or self-designed questionnaires to assess health literacy have revealed a high prevalence of limited or inadequate health literacy, thus providing a challenge to public health. However, these studies typically involve patients in clinical settings and do not consider health literacy at population level. Moreover, they only focus on functional health literacy and do not consider critical or communicative health literacy. In order to measure health literacy at population level and compare the level of health literacy in India to that of other countries it is necessary to use broader measures of health literacy, validated for the Indian population. To that effect, the present study adapted and validated the HLS-EU Q47 for use in India by providing versions in Hindi and Kannada. Hindi is spoken by 52,83,47,193 (44%) of Indians, and Kannada by 4,37,06,512 (3.6%). Methods The original English version of the HLS-EU-Q47, a questionnaire that has been widely used in several European and Asian countries, was translated to Hindi and Kannada by native speakers familiar with health literacy, then back-translated to English and checked for content. The translated versions were then administered to 10 Kannada and Hindi speaking individuals in a “think-aloud” approach to detect any problems in understanding and answering the questions. The time needed to answer the questions and any comments made by the participants were noted and used to refine questions where necessary. A back-translation to English and examination of the content by experts ensured the comparability correctness of the refined questionnaire to the original. The resulting questionnaire was administered a 200 individuals (100 each for Kannada and Hindi) for validation, using stratified purposive sampling based on gender, age, and education level. Selected participants were contacted in person or by e-mail and asked to complete the questionnaire on paper or online. Test re-test reliability was checked in 10% of the participants. Results Validation analyses involving internal consistency analysis for the full scale and subscales (accessing, understanding, evaluating and applying health information, and cure, prevention and health promotion) and association of health literacy with sociodemographic variables, self-reported health and health behaviour are currently under way.
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D Souza, J. P., & Van den Broucke, S. (2019). Validating the HLS-EU-Q47 for the Indian context. 4th European Health Literacy Conference, Dublin. https://hdl.handle.net/2078.5/62024