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Translation and cross-cultural adaptation of the European Health Literacy Survey Questionnaire, HLS-EU-Q16: The Icelandic version

Translation and cross-cultural adaptation of the European Health Literacy Survey Questionnaire, HLS-EU-Q16: The Icelandic version


Title: Translation and cross-cultural adaptation of the European Health Literacy Survey Questionnaire, HLS-EU-Q16: The Icelandic version
Author: Gustafsdottir, Sonja Stelly   orcid.org/0000-0002-1790-4554
Sigurdardottir, Arun K.   orcid.org/0000-0002-4287-5409
Arnadottir, Solveig A   orcid.org/0000-0002-3017-113X
Heimisson, Guðmundur Torfi   orcid.org/0000-0003-3856-2378
Mårtensson, Lena
Date: 2020-01-14
Language: English
Scope: 61
University/Institute: Háskólinn á Akureyri
University of Akureyri
Háskóli Íslands
University of Iceland
School: Heilbrigðisvísindasvið (HA)
School of Health Sciences (UA)
Heilbrigðisvísindasvið (HÍ)
School of Health Sciences (UI)
Hug- og félagsvísindasvið (HA)
School of Humanities and Social Sciences (UA)
Department: Iðjuþjálfunarfræðideild (HA)
Faculty of Occupational Therapy (UA)
Hjúkrunarfræðideild (HA)
Faculty of Nursing (UA)
Sálfræðideild (HA)
Faculty of Psychology (UA)
Læknadeild (HÍ)
Faculty of Medicine (UI)
Series: BMC Public Health;20(1)
ISSN: 1471-2458
DOI: 10.1186/s12889-020-8162-6
Subject: Health; Questionnaires; Heilsufar; Spurningalistar
URI: https://hdl.handle.net/20.500.11815/1624

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Citation:

Gustafsdottir, S. S., Sigurdardottir, A. K., Arnadottir, S. A., Heimisson, G. T., & Mårtensson, L. (2020). Translation and cross-cultural adaptation of the European Health Literacy Survey Questionnaire, HLS-EU-Q16: The icelandic version. BMC Public Health, 20(1), 61. doi:10.1186/s12889-020-8162-6

Abstract:

BACKGROUND: Health literacy (HL) is defined as the knowledge and competences of people to meet the complex demands of health in modern society. It is an important factor in ensuring positive health outcomes, yet Iceland is one of many countries with limited knowledge of HL and no valid HL measurement. The aim of this study was to translate the European Health Literacy Survey Questionnaire- short version (HLS-EU-Q16) into Icelandic, adapt the version, explore its psychometric properties and establish preliminary norms. METHODS: The HLS-EU-Q16 translation model included three steps: 1) translation-back-translation of HLS-EU-Q16 including specialists' review (n = 6); 2) cognitive interviewing of lay people (n = 17); and 3) psychometric analysis with survey participants. The HLS-EU-Q16 includes 16 items, with scores ranges from zero (low/no HL) to 16 (high HL). Statistics included were descriptive, internal consistency measured by Cronbach's α, exploratory factor analysis, and multivariate linear regression. RESULTS: After the translation and cognitive interviewing, 11 of the HLS-EU-Q16 items were reworded to adapt the instrument to Icelandic culture while maintaining their conceptual objectives. Survey participants were 251. Internal consistency of the translated and adapted instrument was α = .88. Four factors with eigenvalues > 1.0 explained 62.6% of variance. Principal component analysis with Oblimin rotation presented four latent constructs, "Processing and Using Information from the Doctor" (4 items, α = .77), "Processing and Using Information from the Family and Media" (4 items, α = .85), "Processing Information in Connection to Healthy Lifestyle" (5 items, α = .76), and "Finding Information about Health Problems/Illnesses" (3 items, α = .73). Lower self-rated health was an independent predictor of lower HL (β = -.484, p = .008). Preliminary norms for HL ranged from five to 16 (M 13.7, SD ± 2.6) with 72.5% with sufficient HL (score 13-16), 22% with problematic HL (score 9-12) and 5.5% with inadequate HL (score 0-8). CONCLUSIONS: The Icelandic version of HLS-EU-Q16 is psychometrically sound, with reasonably clear factor structure, and comparable to the original model. This opens possibilities to study HL in Iceland and compare the results internationally. The translation model introduced might be helpful for other countries where information on HL is missing based on lack of validated tools.

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© The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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