Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis

Abstract Background Accurate measurement of health literacy is essential to improve accessibility and effectiveness of health care and prevention. One measure frequently applied in international research is the Short Assessment of Health Literacy (SAHL). While the Dutch SAHL (SAHL-D) has proven to b...

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Main Authors: A. J. Woudstra, C. S. Meppelink, H. Pander Maat, J. Oosterhaven, M. P. Fransen, A. L. Dima
Format: Article
Language:English
Published: BMC 2019-06-01
Series:BMC Medical Research Methodology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12874-019-0762-4
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author A. J. Woudstra
C. S. Meppelink
H. Pander Maat
J. Oosterhaven
M. P. Fransen
A. L. Dima
author_facet A. J. Woudstra
C. S. Meppelink
H. Pander Maat
J. Oosterhaven
M. P. Fransen
A. L. Dima
author_sort A. J. Woudstra
collection DOAJ
description Abstract Background Accurate measurement of health literacy is essential to improve accessibility and effectiveness of health care and prevention. One measure frequently applied in international research is the Short Assessment of Health Literacy (SAHL). While the Dutch SAHL (SAHL-D) has proven to be valid and reliable, its administration is time consuming and burdensome for participants. Our aim was to further validate, strengthen and shorten the SAHL-D using Rasch analysis. Methods Available cross-sectional SAHL-D data was used from adult samples (N = 1231) to assess unidimensionality, local independence, item fit, person fit, item hierarchy, scale targeting, precision (person reliability and person separation), and presence of differential item functioning (DIF) depending on age, gender, education and study sample. Results Thirteen items for a short form were selected based on item fit and DIF, and scale properties were compared between the two forms. The long form had several items with DIF for age, gender, educational level and study sample. Both forms showed lower measurement precision at higher health literacy levels. Conclusions The findings support the validity and reliability of the SAHL-D for the long form and the short form, which can be used for a rapid assessment of health literacy in research and clinical practice.
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spelling doaj.art-0ae2b92f76d448e8b23fe5c0121024952022-12-22T01:41:06ZengBMCBMC Medical Research Methodology1471-22882019-06-0119111010.1186/s12874-019-0762-4Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysisA. J. Woudstra0C. S. Meppelink1H. Pander Maat2J. Oosterhaven3M. P. Fransen4A. L. Dima5Department of Public Health, Amsterdam Public Health research institute, Academic Medical Center, University of AmsterdamAmsterdam School of Communication Research, University of AmsterdamUtrecht University of Linguistics OTS, Utrecht UniversityResearch Group Lifestyle and Health, University of Applied Sciences UtrechtDepartment of Public Health, Amsterdam Public Health research institute, Academic Medical Center, University of AmsterdamAmsterdam School of Communication Research, University of AmsterdamAbstract Background Accurate measurement of health literacy is essential to improve accessibility and effectiveness of health care and prevention. One measure frequently applied in international research is the Short Assessment of Health Literacy (SAHL). While the Dutch SAHL (SAHL-D) has proven to be valid and reliable, its administration is time consuming and burdensome for participants. Our aim was to further validate, strengthen and shorten the SAHL-D using Rasch analysis. Methods Available cross-sectional SAHL-D data was used from adult samples (N = 1231) to assess unidimensionality, local independence, item fit, person fit, item hierarchy, scale targeting, precision (person reliability and person separation), and presence of differential item functioning (DIF) depending on age, gender, education and study sample. Results Thirteen items for a short form were selected based on item fit and DIF, and scale properties were compared between the two forms. The long form had several items with DIF for age, gender, educational level and study sample. Both forms showed lower measurement precision at higher health literacy levels. Conclusions The findings support the validity and reliability of the SAHL-D for the long form and the short form, which can be used for a rapid assessment of health literacy in research and clinical practice.http://link.springer.com/article/10.1186/s12874-019-0762-4Health literacyMeasurementPublic healthRaschSAHL-DShort-form
spellingShingle A. J. Woudstra
C. S. Meppelink
H. Pander Maat
J. Oosterhaven
M. P. Fransen
A. L. Dima
Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis
BMC Medical Research Methodology
Health literacy
Measurement
Public health
Rasch
SAHL-D
Short-form
title Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis
title_full Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis
title_fullStr Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis
title_full_unstemmed Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis
title_short Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis
title_sort validation of the short assessment of health literacy sahl d and short form development rasch analysis
topic Health literacy
Measurement
Public health
Rasch
SAHL-D
Short-form
url http://link.springer.com/article/10.1186/s12874-019-0762-4
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