Development and validation of a health literacy scale for parents of 4 – 6 years old children

  Objective   To develop a scale for assessing health literacy among parents of the children aged 4 – 6 years and to evaluate the reliability and validity of the scale.

  Methods   We recruited the parents with 4 – 6 years old in Shanghai city. Based on the integrated theoretical model of health literacy proposed by Regional Office for Europe of World Health Organization in 2013, we developed a scale through systematic literature reviews, interviews with experts, and Delphi expert consultations. Then we revised the scale after a pretest and the reliability and validity of the revised scale were evaluated. Critical ratio, correlation coefficient of an item score and total score of the scale, and Cronbach’s alpha coefficient were adopted in item selection.

  Results   The developed 35-item scale consists of 3 subscales for health care, disease prevention, and health promotion and each of the 3 subscales is composed of 4 domains including acquisition, comprehension, evaluation, and application. The results of confirmatory factor analysis demonstrated that the fitting is good for each of the theoretical framework model of the 3 subscales (for health care subscale: χ²/df = 1.138, root mean square error of approximation RMSEA = 0.036, goodness of fit index GFI = 0.919, adjusted goodness of fit index AGFI = 0.870; for disease prevention: χ²/df = 1.136, RMSEA = 0.036, GFI = 0.892, AGFI = 0.845; and for health promotion: χ²/df = 0.525, RMSEA = 0.000, GFI = 0.988, AGFI = 0.961). The Cronbach’s alpha coefficient was 0.823 for the whole scale and 0.661, 0.717, and 0.641 for the 3 subscales; the split-half reliability was 0.834 for the whole scale and 0.677, 0.729, and 0.642 for the 3 subscales; and the test-retest reliability was 0.726 for the whole scale and 0.696, 0.718, and 0.666 for the 3 subscales, respectively.

  Conclusion   The developed health literacy scale for parents of 4 – 6 years old children is of good reliability and validity and the scale could be used as an instrument for assessing health literacy of the parents.