You are not logged in.
Openly accessible

Measuring health literacy in community agencies: a Bayesian study of the factor structure and measurement invariance of the Health Literacy Questionnaire (HLQ)

Elsworth, Gerald R., Beauchamp, Alison and Osborne, Richard H. 2016, Measuring health literacy in community agencies: a Bayesian study of the factor structure and measurement invariance of the Health Literacy Questionnaire (HLQ), BMC health services research, vol. 16, Article number: 508, pp. 1-14, doi: 10.1186/s12913-016-1754-2.

Attached Files
Name Description MIMEType Size Downloads
elsworth-measuringhealth-2016.pdf Published version application/pdf 606.23KB 20

Title Measuring health literacy in community agencies: a Bayesian study of the factor structure and measurement invariance of the Health Literacy Questionnaire (HLQ)
Author(s) Elsworth, Gerald R.ORCID iD for Elsworth, Gerald R. orcid.org/0000-0001-6306-7593
Beauchamp, AlisonORCID iD for Beauchamp, Alison orcid.org/0000-0001-6555-6200
Osborne, Richard H.ORCID iD for Osborne, Richard H. orcid.org/0000-0002-9081-2699
Journal name BMC health services research
Volume number 16
Season Article number: 508
Start page 1
End page 14
Total pages 14
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2016-09-22
ISSN 1472-6963
Keyword(s) health literacy
Health Literacy Questionnaire
HLQ
Bayesian structural modelling
BSEM
measurement invariance
Bayesian structural equation modelling
Summary Background The development of the Health Literacy Questionnaire (HLQ), reported in 2013, attracted widespread international interest. While the original study samples were drawn from clinical and home-based aged-care settings, the HLQ was designed for the full range of healthcare contexts including community-based health promotion and support services. We report a follow-up study of the psychometric properties of the HLQ with respondents from a diverse range of community-based organisations with the principal goal of contributing to the development of a soundly validated evidence base for its use in community health settings.

Methods Data were provided by 813 clients of 8 community agencies in Victoria, Australia who were administered the HLQ during the needs assessment stage of the Ophelia project, a health literacy-based intervention. Most analyses were conducted using Bayesian structural equation modelling that enables rigorous analysis of data but with some relaxation of the restrictive requirements for zero cross-loadings and residual correlations of ‘classical’ confirmatory factor analysis. Scale homogeneity was investigated with one-factor models that allowed for the presence of small item residual correlations while discriminant validity was studied using the inter-factor correlations and factor loadings from a full 9-factor model with similar allowance for small residual correlations and cross-loadings. Measurement invariance was investigated scale-by-scale using a model that required strict invariance of item factor loadings, thresholds, residual variances and co-variances.

Results All HLQ scales were found to be homogenous with composite reliability ranging from 0.80 to 0.89. The factor structure of the HLQ was replicated and 6 of the 9 scales were found to exhibit clear-cut discriminant validity. With a small number of exceptions involving non-invariance of factor loadings, strict measurement invariance was established across the participating organisations and the gender, language background, age and educational level of respondents.

Conclusions The HLQ is highly reliable, even with only 4 to 6 items per scale. It provides unbiased mean estimates of group differences across key demographic indicators. While measuring relatively narrow constructs, the 9 dimensions are clearly separate and therefore provide fine-grained data on the multidimensional area of health literacy. These analyses provide researchers, program managers and policymakers with a range of robust evidence by which they can make judgements about the appropriate use of the HLQ for their community-based setting.
Language eng
DOI 10.1186/s12913-016-1754-2
Field of Research 111799 Public Health and Health Services not elsewhere classified
1117 Public Health And Health Services
0807 Library And Information Studies
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30087579

Document type: Journal Article
Collections: Population Health
Open Access Collection
Connect to link resolver
 
Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved.

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.

Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 5 times in TR Web of Science
Scopus Citation Count Cited 5 times in Scopus
Google Scholar Search Google Scholar
Access Statistics: 60 Abstract Views, 20 File Downloads  -  Detailed Statistics
Created: Fri, 14 Oct 2016, 14:04:09 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.