Development of a Health Literacy Scale for Chinese-Speaking Adults in Taiwan
Background, measuring an individual-s Health
Literacy is gaining attention, yet no appropriate instrument is available
in Taiwan. Measurement tools that were developed and used in
western countries may not be appropriate for use in Taiwan due to a
different language system. Purpose of this research was to develop a
Health Literacy measurement instrument specific for Taiwan adults.
Methods, several experts of clinic physicians; healthcare
administrators and scholars identified 125 common used health related
Chinese phrases from major medical knowledge sources that easy
accessible to the public. A five-point Likert scale is used to measure
the understanding level of the target population. Such measurement is
then used to compare with the correctness of their answers to a health
knowledge test for validation. Samples, samples under study were
purposefully taken from four groups of people in the northern
Pingtung, OPD patients, university students, community residents,
and casual visitors to the central park. A set of health knowledge index
with 10 questions is used to screen those false responses. A sample
size of 686 valid cases out of 776 was then included to construct this
scale. An independent t-test was used to examine each individual
phrase. The phrases with the highest significance are then identified
and retained to compose this scale. Result, a Taiwan Health Literacy
Scale (THLS) was finalized with 66 health-related phrases under nine
divisions. Cronbach-s alpha of each division is at a satisfactory level
of 89% and above. Conclusions, factors significantly differentiate the
levels of health literacy are education, female gender, age, family
members of stroke victims, experience with patient care, and
healthcare professionals in the initial application in this study..
[1] B. D. Weiss, "Health literacy: An important issue for communicating
health information to patients." Chinese Medical Journal, vol. 64, pp.
603-608, 2001.
[2] D. A. DeWalt, N. D. Berkman, S. Sheridan, K. N. Lohr, and M. P.
Pignone, "Literacy and health outcomes- A systematic review of the
literature." Journal of General Internal Medicine, vol. 9, pp. 1228-39,
2004.
[3] R. M. Cervero, "Is a common definition of adult literacy possible? Adult
Education Quarterly, vol. 36(1), pp. 50-54, 1985.
[4] S. Imel, and S. Grieve, Adult Literacy Education. Overview. Columbus,
Ohio: ERIC Clearinghouse on Adult, Career and Vocational Education.
(ERIC Document Reproduction Service No. ED 259 210), 1985.
[5] K. Levine, The Social Context of Literacy. London: Rutledge & Kegan,
1986.
[6] H. A. Fingeret, Adult Literacy Education: Current and Future Directions.
Columbus, Ohio: ERIC Clearinghouse on Adult, Career and Vocational
Education. (ERIC Document Reproduction Service No. ED 345
391),1992.
[7] A. Campbell, I. Kirsch, and A. Kolstad, Assessing Literacy: The
Framework for the National Adult Literacy Survey. Princeton:
Educational Testing Service, 1992.
[8] C. S. J. Hunter, and D. Harman, Adult Illiteracy in the United States: A
Report to the Ford Foundation. New York: McGraw-Hill, 1979.
[9] G. S. Wilkinson, Wide Range Achievement Test. Administration Manual.
Wilmington, Del: Wide Range, 1993.
[10] G. S. Wilkinson, and G. J. Robertson, Wide Range Achievement Test-4th
Ed. Lutz, FL: Psychological Assessment Resources, 2006.
[11] H. S. Lin, S. S. Chen, M. L. Kwo, and C. Hwang, "Health literacy in
Taiwan: A pilot study." Taiwan Joint Conference in Health Care (c5-c6),
Taipei, 2007. (in Chinese)
[12] H. J. Chiou Quantitative Research and Statistical Analysis in Social &
Behavioral Sciences. Taipei: Wunan, 2005. (in Chinese).
[13] A. A. Al-Tayyib, S. M. Rogers, J. N. Gribble, M. Villarroe, and C. F.
Turner, "Effect of low medical literacy on health survey measurements."
American Journal of Public Health, vol. 92, pp.1478-1481, 2002.
[14] World Health Organization, Health Promotion Glossary. Geneva,
Switzerland: Division of Health Promotion, Education and
Communications (HPR), Health Education and Health Promotion Unit
(HEP), p. 10, 1998.
[15] National Library of Medicine, Current bibliographies in medicine:
Health literacy. Bethesda, Maryland: U.S Department of Health and
Human Services, National Institutes of Health, 2000.
[16] D. Nutbeam, "Health literacy as a public health goal: A challenge for
contemporary health education and communication strategies into the
21st century." Health Promotion International, vol. 15, pp. 259-67, 2000.
[17] US Department of Health and Human Services, Office of Disease
Prevention and Health Promotion, Healthy People 2010.
http://www.health.gov/healthypeople (Retrieved at July 15, 2010).
[18] S-Y. D. Lee, A. M. Arozullah, and Y. I. Cho. "Health literacy, social
support, and health: a research agenda." Social Science & Medicine, vol.
58, pp. 1309-1321, 2004
[1] B. D. Weiss, "Health literacy: An important issue for communicating
health information to patients." Chinese Medical Journal, vol. 64, pp.
603-608, 2001.
[2] D. A. DeWalt, N. D. Berkman, S. Sheridan, K. N. Lohr, and M. P.
Pignone, "Literacy and health outcomes- A systematic review of the
literature." Journal of General Internal Medicine, vol. 9, pp. 1228-39,
2004.
[3] R. M. Cervero, "Is a common definition of adult literacy possible? Adult
Education Quarterly, vol. 36(1), pp. 50-54, 1985.
[4] S. Imel, and S. Grieve, Adult Literacy Education. Overview. Columbus,
Ohio: ERIC Clearinghouse on Adult, Career and Vocational Education.
(ERIC Document Reproduction Service No. ED 259 210), 1985.
[5] K. Levine, The Social Context of Literacy. London: Rutledge & Kegan,
1986.
[6] H. A. Fingeret, Adult Literacy Education: Current and Future Directions.
Columbus, Ohio: ERIC Clearinghouse on Adult, Career and Vocational
Education. (ERIC Document Reproduction Service No. ED 345
391),1992.
[7] A. Campbell, I. Kirsch, and A. Kolstad, Assessing Literacy: The
Framework for the National Adult Literacy Survey. Princeton:
Educational Testing Service, 1992.
[8] C. S. J. Hunter, and D. Harman, Adult Illiteracy in the United States: A
Report to the Ford Foundation. New York: McGraw-Hill, 1979.
[9] G. S. Wilkinson, Wide Range Achievement Test. Administration Manual.
Wilmington, Del: Wide Range, 1993.
[10] G. S. Wilkinson, and G. J. Robertson, Wide Range Achievement Test-4th
Ed. Lutz, FL: Psychological Assessment Resources, 2006.
[11] H. S. Lin, S. S. Chen, M. L. Kwo, and C. Hwang, "Health literacy in
Taiwan: A pilot study." Taiwan Joint Conference in Health Care (c5-c6),
Taipei, 2007. (in Chinese)
[12] H. J. Chiou Quantitative Research and Statistical Analysis in Social &
Behavioral Sciences. Taipei: Wunan, 2005. (in Chinese).
[13] A. A. Al-Tayyib, S. M. Rogers, J. N. Gribble, M. Villarroe, and C. F.
Turner, "Effect of low medical literacy on health survey measurements."
American Journal of Public Health, vol. 92, pp.1478-1481, 2002.
[14] World Health Organization, Health Promotion Glossary. Geneva,
Switzerland: Division of Health Promotion, Education and
Communications (HPR), Health Education and Health Promotion Unit
(HEP), p. 10, 1998.
[15] National Library of Medicine, Current bibliographies in medicine:
Health literacy. Bethesda, Maryland: U.S Department of Health and
Human Services, National Institutes of Health, 2000.
[16] D. Nutbeam, "Health literacy as a public health goal: A challenge for
contemporary health education and communication strategies into the
21st century." Health Promotion International, vol. 15, pp. 259-67, 2000.
[17] US Department of Health and Human Services, Office of Disease
Prevention and Health Promotion, Healthy People 2010.
http://www.health.gov/healthypeople (Retrieved at July 15, 2010).
[18] S-Y. D. Lee, A. M. Arozullah, and Y. I. Cho. "Health literacy, social
support, and health: a research agenda." Social Science & Medicine, vol.
58, pp. 1309-1321, 2004
@article{"International Journal of Business, Human and Social Sciences:62722", author = "Frank C. Pan and Che-Long Su and Ching-Hsuen Chen", title = "Development of a Health Literacy Scale for Chinese-Speaking Adults in Taiwan", abstract = "Background, measuring an individual-s Health
Literacy is gaining attention, yet no appropriate instrument is available
in Taiwan. Measurement tools that were developed and used in
western countries may not be appropriate for use in Taiwan due to a
different language system. Purpose of this research was to develop a
Health Literacy measurement instrument specific for Taiwan adults.
Methods, several experts of clinic physicians; healthcare
administrators and scholars identified 125 common used health related
Chinese phrases from major medical knowledge sources that easy
accessible to the public. A five-point Likert scale is used to measure
the understanding level of the target population. Such measurement is
then used to compare with the correctness of their answers to a health
knowledge test for validation. Samples, samples under study were
purposefully taken from four groups of people in the northern
Pingtung, OPD patients, university students, community residents,
and casual visitors to the central park. A set of health knowledge index
with 10 questions is used to screen those false responses. A sample
size of 686 valid cases out of 776 was then included to construct this
scale. An independent t-test was used to examine each individual
phrase. The phrases with the highest significance are then identified
and retained to compose this scale. Result, a Taiwan Health Literacy
Scale (THLS) was finalized with 66 health-related phrases under nine
divisions. Cronbach-s alpha of each division is at a satisfactory level
of 89% and above. Conclusions, factors significantly differentiate the
levels of health literacy are education, female gender, age, family
members of stroke victims, experience with patient care, and
healthcare professionals in the initial application in this study..", keywords = "Health literacy, health knowledge, REALM, THLS.", volume = "4", number = "1", pages = "55-7", }