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Quality of Life Research

Erschienen in:

10.07.2023

Measuring skill-based health literacy in chronic airway disease patients: the development and psychometric evaluation of the Vancouver airways health literacy tool (VAHLT)

verfasst von: Richard E. Hohn, Jacek A. Kopec, Richard Sawatzky, Iraj Poureslami, J. Mark FitzGerald

Erschienen in: Quality of Life Research | Ausgabe 10/2023

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Abstract

Purpose

This article describes the development of the Vancouver airways health literacy tool (VAHLT), a novel measure of skill-based health literacy specific to chronic airway diseases (CADs). Across several phases, psychometric characteristics of the VAHLT were examined and used to guide its development.

Methods

An initial pool of 46 items was developed using input from patients, clinicians, researchers, and policy-makers. An initial patient sample (N = 532) was evaluated and used to inform item revisions. A revised 44-item pool was then evaluated using a second sample, the results of which aided in the selection of a final set of 30 items. The finalized 30-item VAHLT was then psychometrically evaluated using the second sample (N = 318).

An item response theory approach was utilized to evaluate the VAHLT by assessing model fit, item parameter estimates, test and item information curves, and item characteristic curves. Reliability was assessed using ordinal coefficient alpha. We additionally assessed differential item functioning between asthma and COPD diagnoses.

Results

The VAHLT demonstrated a unidimensional structure and reasonably discriminated patients in the lower range of health literacy estimates. The tool demonstrated strong reliability (α = .920). Two of the 30 items were found to exhibit non-negligible differential item functioning.

Conclusions

This study presents compelling evidence of validity in several areas for the VAHLT, including content and structural validity. Further external validation studies are needed and forthcoming. Overall, this work represents a strong first step towards a novel, skill-based, and disease-specific measure of CAD-related health literacy.

Pleasant, A., Maish, C., O’Leary, C., & Carmona, R. H. (2018). A theory-based self-report measure of health literacy: The calgary charter on health literacy scale. Methodological Innovations, 11(3), 1–9. https://doi.org/10.1177/2059799118814394CrossRef

Rootman, I., & Gordon-El-Bihbety, D. (2008). A vision for a health literate Canada report of the Expert Panel on Health Literacy. Canadian Public Health Association: Ottawa, ON, Canada. https://www.cpha.ca/sites/default/files/uploads/resources/healthlit/report_e.pdf

Institute of Medicine Committee on Health Literacy. (2004). Health literacy: A prescription to end confusion. The National Academies Press.

Protheroe, J., Nutbeam, D., & Rowlands, G. (2009). Health literacy: A necessity for increasing participation in health care. British Journal of General Practice, 59(567), 721–723. https://doi.org/10.3399/bjgp09X472584CrossRef

Yadav, U. N., Lloyd, J., Hosseinzadeh, H., Baral, K. P., & Harris, M. F. (2020). Do chronic obstructive pulmonary diseases (COPD) self-management interventions consider health literacy and patient activation? A systematic review. Journal of Clinical Medicine, 9(3), 646. https://doi.org/10.3390/jcm9030646CrossRefPubMedPubMedCentral

Tavousi, M., Mohammadi, S., Sadighi, J., Zarei, F., Kermani, R. M., Rostami, R., & Montazeri, A. (2022). Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021. PLoS ONE, 17(7), e0271524. https://doi.org/10.1371/journal.pone.0271524CrossRefPubMedPubMedCentral

Davis, T. C., Long, S. W., Jackson, R. H., et al. (1993). Rapid estimate of adult literacy in medicine (REALM): A shortened screening instrument. Family Medicine, 25(6), 391–395.PubMed

Parker, R. M., Baker, D. W., Williams, M. V., & Nurss, J. R. (1995). The test of functional health literacy in adults: A new instrument for measuring patients’ literacy skills. Journal of General Internal Medicine, 10(10), 537–541. https://doi.org/10.1007/BF02640361CrossRefPubMed

Shum, J., Poureslami, I., Wiebe, D., Doyle-Waters, M. M., Nimmon, L., Fitzgerald, J. M., Canadian Airways Health Literacy Study Group. (2018). Airway diseases and health literacy (HL) measurement tools: A systematic review to inform respiratory research and practice. Patient Education and Counseling, 101, 596–618. https://doi.org/10.1016/j.pec.2017.10.011CrossRefPubMed

10.

Poureslami, I., Kopec, J., Tregobov, N., Shum, J., Sawatzky, R., Hohn, R. E., & FitzGerald, J. M. (2021). An integrated framework to conceptualize and develop the vancouver airways health literacy tool (VAHLT). International Journal of Environmental Research and Public Health, 18(16), 8646.CrossRefPubMedPubMedCentral

11.

Duell, P., Wright, D., Renzaho, A. M., & Bhattacharya, D. (2015). Optimal health literacy measurement for the clinical setting: A systematic review. Patient Education and Counseling, 98(11), 1295–1307. https://doi.org/10.1016/j.pec.2015.04.003CrossRefPubMed

12.

Kronzer, V. L. (2016). Screening for health literacy is not the answer. BMJ, 354, i3699. https://doi.org/10.1136/bmj.i3699CrossRefPubMed

13.

Sun, X., Chen, J., Shi, Y., Zeng, Q., Wei, N., Xie, R., & Du, W. (2013). Measuring health literacy regarding infectious respiratory diseases: A new skills-based instrument. PLoS ONE, 8(5), e64153. https://doi.org/10.1371/journal.pone.0064153CrossRefPubMedPubMedCentral

14.

Poureslami, I., Shum, J., Kopec, J., Sawatzky, R., Gupta, S., Pakhale, S., Canadian Airways Health Literacy Study Group. (2020). Development and pretesting of a new functional-based health literacy measurement tool for chronic obstructive pulmonary disease (COPD) and asthma management. International Journal of Chronic Obstructive Pulmonary Disease, 15, 613–625. https://doi.org/10.2147/COPD.S234418CrossRefPubMedPubMedCentral

15.

Slocum-Gori, S. L., & Zumbo, B. D. (2010). Assessing the unidimensionality of psychological scales: Using multiple criteria from factor analysis. Social Indicators Research, 102(3), 443–461. https://doi.org/10.1007/s11205-010-9682-8CrossRef

16.

de Ayala, R. J. (2009). The theory and practice of item response theory. The Guilford Press.

17.

Cai, L., & Hansen, M. (2013). Limited-information goodness-of-fit testing of hierarchical item factor models. British Journal of Mathematical and Statistical Psychology, 66(2), 245–276. https://doi.org/10.1111/j.2044-8317.2012.02050.xCrossRefPubMed

18.

Cai L & Monroe S (2014) A new statistic for evaluating item response theory models for ordinal data. National Center for Research on Evaluation Standards & Student Testing. Technical Report https://cresst.org/publications/cresst-publication-3208/

19.

Maydeu-Olivares, A., & Joe, H. (2006). Limited information goodness-of-fit testing in multidimensional contingency tables. Psychometrika, 71(4), 713–732. https://doi.org/10.1007/s11336-005-1295-9CrossRef

20.

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118CrossRef

21.

Zumbo, B. D., Gadermann, A. M., & Zeisser, C. (2007). Ordinal versions of coefficients alpha and theta for likert rating scales. Journal of Modern Applied Statistical Methods, 6(1), 21–29. https://doi.org/10.22237/jmasm/1177992180CrossRef

22.

R Core Team (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/.

23.

Muthén, L. K., & Muthén, B. O. (2020). Mplus User’s Guide (8th ed.). Muthén & Muthén.

24.

Chalmers, R. P. (2012). Mirt: A multidimensional item response theory package for the R environment. Journal of Statistical Software, 48(6), 1–29. https://doi.org/10.18637/jssCrossRef

25.

Raju, N. S. (1990). Determining the significance of estimated signed and unsigned areas between two item response functions. Applied Psychological Measurement, 14, 197–207. https://doi.org/10.1177/014662169001400208CrossRef

26.

Wright, K. D., & Oshima, T. C. (2015). An effect size measure for Raju’s differential functioning for items and tests. Educational and Psychological Measurement, 75(2), 338–358. https://doi.org/10.1177/0013164414532944.

27.

Agarwal, P., Lin, J., Muellers, K., O’Conor, R., Wolf, M., Federman, A. D., & Wisnivesky, J. P. (2020). A structural equation model of relationships of health literacy, illness and medication beliefs with medication adherence among patients with chronic obstructive pulmonary disease. Patient Education and Counseling, 104(6), 1445–1450. https://doi.org/10.1016/j.pec.2020.11.024CrossRefPubMedPubMedCentral

28.

Curtis, L. M., Wolf, M. S., Weiss, K. B., & Grammer, L. C. (2012). The impact of health literacy and socioeconomic status on asthma disparities. Journal of Asthma, 49(2), 78–183. https://doi.org/10.3109/02770903.2011.648297CrossRef

29.

Salim, H., Ramdzan, S. N., Ghazali, S. S., Lee, P. Y., Young, I., McClatchey, K., & Pinnock, H. (2020). A systematic review of interventions addressing limited health literacy to improve asthma self-management. Journal of Global Health, 10(1), 010427. https://doi.org/10.7189/jogh.10.010428CrossRefPubMedPubMedCentral

30.

Shnaigat, M., Downie, S., & Hosseinzadeh, H. (2021). Effectiveness of health literacy interventions on COPD self-management outcomes in outpatient settings: A systematic review. Journal of Chronic Obstructive Pulmonary Disease, 18(3), 367–373. https://doi.org/10.1080/15412555.2021.1872061CrossRefPubMed

31.

Wiebe, D., Fitzgerald, J. M., Shum, J., & Poureslami, I. (2016). A preliminary framework for the development of a health literacy measurement tool for asthma and COPD. Chest Journal, 150(4), 633A. https://doi.org/10.1016/j.chest.2016.08.725CrossRef

Titel: Measuring skill-based health literacy in chronic airway disease patients: the development and psychometric evaluation of the Vancouver airways health literacy tool (VAHLT)
verfasst von: Richard E. Hohn
Jacek A. Kopec
Richard Sawatzky
Iraj Poureslami
J. Mark FitzGerald
Publikationsdatum: 10.07.2023
Verlag: Springer International Publishing
Erschienen in: Quality of Life Research / Ausgabe 10/2023
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-023-03447-5

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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