Development and validation of Chinese Health Literacy Scale for Diabetes

Aims and objectives To develop and to test the psychometric properties of the Chinese Health Literacy Scale for Diabetes. Background Patients with diabetes encounter many challenges when making health decisions in their daily lives, as they have access to many different kinds of health information. Health literacy issues are new topics in Chinese society. Without a valid and reliable instrument in Chinese, it is difficult to measure the level of health literacy and promote the concept of health literacy in Chinese societies. Design A methodological study with a sample of 137 patients with type 2 diabetes aged 65years or older. Method Chinese Health Literacy Scale for Diabetes was developed with reference to the revised Bloom's taxonomy model. Psychometric tests (content validity, item analysis, construct validity, discriminative ability and test-retest reliability) were conducted. Correlations between Chinese Health Literacy Scale for Diabetes and four relevant measures were tested. Cronbach's alpha and alpha if item deleted were calculated to assess internal consistency. Results Cronbach's alpha for Chinese Health Literacy Scale for Diabetes and its four subscales (remembering, understanding, applying and analysing) were 0<bold>884</bold>, 0<bold>885</bold>, 0<bold>667</bold>, 0<bold>654</bold> and 0<bold>717</bold>, respectively. The Chinese Health Literacy Scale for Diabetes was significantly correlated with the Diabetic Knowledge Scale (r=0<bold>398</bold>, p<0<bold>001</bold>), the Diabetic Management Self-Efficacy Scale (r=0<bold>257</bold>, p<0<bold>001</bold>), the Preschool and Primary Chinese Literacy Scale (r=0<bold>822</bold>, p<0<bold>001</bold>) and the Chinese Value of Learning Scale (r=0<bold>303</bold>, p<0<bold>001</bold>). It took an average of sevenminutes to complete this 34-item instrument. Conclusion The findings of this study support the Chinese Health Literacy Scale for Diabetes as a reliable and valid instrument for measuring the health literacy of Chinese patients with diabetes. Relevance to clinical practiceWe recommend that clinicians use this tool to assess patients' health literacy before conducting any kind of health promotion.