European health literacy survey questionnaire short form (HLS-Q12): adaptation and evidence of validity for the Brazilian context

Health literacy (HL) refers to knowledge, motivation and skills to understand, evaluate and apply health information, enabling appropriate decision making in daily life on health care and health promotion. Studies show that HL is associated with several social determinants, health outcomes, and health promotion. In Brazil, studies on the thematic are still scarce. Thus, the present study aimed to adapt, seek evidence of validity, reliability and estimate the parameters of the items of the European Health Literacy Survey Questionnaire Short Form (HLS-Q12) for the Brazilian context. 770 individuals participated, recruited through advertisements in the media and social networks, 82.1% female, aged between 18 and 83 (M = 35.5, SD = 13.52), from 21 Federative Units of Brazil and the Federal District. The subjects answered the HLS-Q12 and a sociodemographic questionnaire. Exploratory factor analysis indicated a unifactorial structure with good psychometric characteristics (GFI = 0.98; CFI = 0.98; RMSEA = 0.08; RMSR = 0.07). Cronbach's alpha, Guttman's lambda 2 and McDonald's omega reliability indicators were equal to 0.87. We conclude that the HLS-Q12 is an adequate instrument to assess the level of HL in the Brazilian population. Literacia em saude (LS) refere-se ao conhecimento, motivacao e competencias para entender, avaliar e aplicar informacoes de saude, possibilitando a tomada de decisoes adequadas na vida diaria para o cuidado e promocao de saude. Estudos apontam que a LS esta associada a diversos determinantes sociais, desfechos em saude e promocao da saude. No Brasil ainda sao escassos os estudos no tema. Dessa forma, o presente estudo objetivou adaptar, buscar evidencias de validade, fidedignidade e estimar os parametros dos itens do European Health Literacy Survey Questionnaire Short Form (HLS-Q12) para o contexto brasileiro. Participaram 770 individuos, recrutados por meio de anuncios nas midias e redes sociais, 82,1% mulheres, com idades entre 18 e 83 anos (M = 35,5, DP = 13,52), de 21 Unidades Federativas do Brasil e do Distrito Federal. Os sujeitos responderam a HLS-Q12 e questionario sociodemografico. A analise fatorial exploratoria indicou uma estrutura unifatorial com bons parametros psicometricos (GFI = 0,98; CFI = 0,98; RMSEA = 0,08; RMSR = 0,07). Os indicadores de fidedignidade alfa de Cronbach, lambda 2 de Guttman e omega de McDonald foram iguais a 0,87. Conclui-se que o HLS-Q12 apresenta-se como um instrumento adequado para aferir o nivel de LS na populacao brasileira.