Maria L Jibaja-Weiss, Robert J Volk
Utilizing computerized entertainment education in the development of decision aids for lower literate and naïve computer users
Journal of health communication
many health literacy instruments focus reading skills numeracy andor information processing aspects netherlands countries need comprehensive personcentred measure health literacy observed consequently decision made translate health literacy questionnaire hlq dutch hlq nine health literacy domains covering peoples experiences skills research sought translate culturally adapt psychometrically test hlq translation adaptation done using systematic approach forward translation guided item intents blind back translation consensus meeting developer dutch version hlq applied sample nonhospitalized chronically ill patients descriptive statistics generated describe mean standard deviation floor ceiling effects items confirmatory factor analysis cfa model fitted data scores nine domains hlq compared across demographic illness characteristics form knowngroups validity psychometric analyses included cronbachs alpha itemrest itemremainder correlations using cfa dutch hlq psychometric structure found strongly align hypothesised original nine independent domains english version nine scales found highly reliable scales alpha 083 094 six nine hlqscales items show ceilingeffects ceiling effects present scale level scores scales hlq differed according demographic illness characteristics people older lower educated living alone patients multiple chronic diseases generally scored lower dutch version hlq robust reliable instrument measures nine different domains health literacy questionnaire tested sample chronically ill patients tested general population well different disease groups hlq major addition currently available instruments netherlands since measures health literacy multidimensional perspective builds patients experiences skills