Measurement properties of the Health Literacy Questionnaire (HLQ) among older adults who present to the emergency department after a fall: A Rasch analysis

Rebecca L Morris, Sze-Ee Soh, Keith Hill, Rachelle Buchbinder, Judy A Lowthian, Julie Redfern, Christopher D Etherton-Beer, Anne-Marie Hill, Richard H Osborne, Glenn Arendts, Anna L Barker

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Health literacy is an important concept associated with participation in preventive health initiatives, such as falls prevention programs. A comprehensive health literacy measurement tool, appropriate for this population, is required. The aim of this study was to evaluate the measurement properties of the Health Literacy Questionnaire (HLQ) in a cohort of older adults who presented to a hospital emergency department (ED) after a fall. Methods: Older adults who presented to an ED after a fall had their health literacy assessed using the HLQ (n = 433). Data were collected as part of a multi-centre randomised controlled trial of a falls prevention program. Measurement properties of the HLQ were assessed using Rasch analysis. Results: All nine scales of the HLQ were unidimensional, with good internal consistency reliability. No item bias was found for most items (43 of 44). A degree of overall misfit to the Rasch model was evident for six of the nine HLQ scales. The majority of misfit indicated content overlap between some items and does not compromise measurement. A measurement gap was identified for this cohort at mid to high HLQ score. Conclusions: The HLQ demonstrated good measurement properties in a cohort of older adults who presented to an ED after a fall. The summation of the HLQ items within each scale, providing unbiased information on nine separate areas of health literacy, is supported. Clinicians, researchers and policy makers may have confidence using the HLQ scale scores to gain information about health literacy in older people presenting to the ED after a fall. Trial registration: This study was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12614000336684 (27 March 2014).

Original languageEnglish
Article number605
Number of pages11
JournalBMC Health Services Research
Volume17
Issue number1
DOIs
Publication statusPublished - 29 Aug 2017

Cite this

@article{5fc77f8202a84e499d5df4218df6d255,
title = "Measurement properties of the Health Literacy Questionnaire (HLQ) among older adults who present to the emergency department after a fall: A Rasch analysis",
abstract = "Background: Health literacy is an important concept associated with participation in preventive health initiatives, such as falls prevention programs. A comprehensive health literacy measurement tool, appropriate for this population, is required. The aim of this study was to evaluate the measurement properties of the Health Literacy Questionnaire (HLQ) in a cohort of older adults who presented to a hospital emergency department (ED) after a fall. Methods: Older adults who presented to an ED after a fall had their health literacy assessed using the HLQ (n = 433). Data were collected as part of a multi-centre randomised controlled trial of a falls prevention program. Measurement properties of the HLQ were assessed using Rasch analysis. Results: All nine scales of the HLQ were unidimensional, with good internal consistency reliability. No item bias was found for most items (43 of 44). A degree of overall misfit to the Rasch model was evident for six of the nine HLQ scales. The majority of misfit indicated content overlap between some items and does not compromise measurement. A measurement gap was identified for this cohort at mid to high HLQ score. Conclusions: The HLQ demonstrated good measurement properties in a cohort of older adults who presented to an ED after a fall. The summation of the HLQ items within each scale, providing unbiased information on nine separate areas of health literacy, is supported. Clinicians, researchers and policy makers may have confidence using the HLQ scale scores to gain information about health literacy in older people presenting to the ED after a fall. Trial registration: This study was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12614000336684 (27 March 2014).",
author = "Morris, {Rebecca L} and Sze-Ee Soh and Keith Hill and Rachelle Buchbinder and Lowthian, {Judy A} and Julie Redfern and Etherton-Beer, {Christopher D} and Anne-Marie Hill and Osborne, {Richard H} and Glenn Arendts and Barker, {Anna L}",
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doi = "10.1186/s12913-017-2520-9",
language = "English",
volume = "17",
journal = "BMC Health Services Research",
issn = "1472-6963",
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Measurement properties of the Health Literacy Questionnaire (HLQ) among older adults who present to the emergency department after a fall : A Rasch analysis. / Morris, Rebecca L; Soh, Sze-Ee; Hill, Keith; Buchbinder, Rachelle; Lowthian, Judy A; Redfern, Julie; Etherton-Beer, Christopher D; Hill, Anne-Marie; Osborne, Richard H; Arendts, Glenn; Barker, Anna L.

In: BMC Health Services Research, Vol. 17, No. 1, 605, 29.08.2017.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Measurement properties of the Health Literacy Questionnaire (HLQ) among older adults who present to the emergency department after a fall

T2 - A Rasch analysis

AU - Morris, Rebecca L

AU - Soh, Sze-Ee

AU - Hill, Keith

AU - Buchbinder, Rachelle

AU - Lowthian, Judy A

AU - Redfern, Julie

AU - Etherton-Beer, Christopher D

AU - Hill, Anne-Marie

AU - Osborne, Richard H

AU - Arendts, Glenn

AU - Barker, Anna L

PY - 2017/8/29

Y1 - 2017/8/29

N2 - Background: Health literacy is an important concept associated with participation in preventive health initiatives, such as falls prevention programs. A comprehensive health literacy measurement tool, appropriate for this population, is required. The aim of this study was to evaluate the measurement properties of the Health Literacy Questionnaire (HLQ) in a cohort of older adults who presented to a hospital emergency department (ED) after a fall. Methods: Older adults who presented to an ED after a fall had their health literacy assessed using the HLQ (n = 433). Data were collected as part of a multi-centre randomised controlled trial of a falls prevention program. Measurement properties of the HLQ were assessed using Rasch analysis. Results: All nine scales of the HLQ were unidimensional, with good internal consistency reliability. No item bias was found for most items (43 of 44). A degree of overall misfit to the Rasch model was evident for six of the nine HLQ scales. The majority of misfit indicated content overlap between some items and does not compromise measurement. A measurement gap was identified for this cohort at mid to high HLQ score. Conclusions: The HLQ demonstrated good measurement properties in a cohort of older adults who presented to an ED after a fall. The summation of the HLQ items within each scale, providing unbiased information on nine separate areas of health literacy, is supported. Clinicians, researchers and policy makers may have confidence using the HLQ scale scores to gain information about health literacy in older people presenting to the ED after a fall. Trial registration: This study was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12614000336684 (27 March 2014).

AB - Background: Health literacy is an important concept associated with participation in preventive health initiatives, such as falls prevention programs. A comprehensive health literacy measurement tool, appropriate for this population, is required. The aim of this study was to evaluate the measurement properties of the Health Literacy Questionnaire (HLQ) in a cohort of older adults who presented to a hospital emergency department (ED) after a fall. Methods: Older adults who presented to an ED after a fall had their health literacy assessed using the HLQ (n = 433). Data were collected as part of a multi-centre randomised controlled trial of a falls prevention program. Measurement properties of the HLQ were assessed using Rasch analysis. Results: All nine scales of the HLQ were unidimensional, with good internal consistency reliability. No item bias was found for most items (43 of 44). A degree of overall misfit to the Rasch model was evident for six of the nine HLQ scales. The majority of misfit indicated content overlap between some items and does not compromise measurement. A measurement gap was identified for this cohort at mid to high HLQ score. Conclusions: The HLQ demonstrated good measurement properties in a cohort of older adults who presented to an ED after a fall. The summation of the HLQ items within each scale, providing unbiased information on nine separate areas of health literacy, is supported. Clinicians, researchers and policy makers may have confidence using the HLQ scale scores to gain information about health literacy in older people presenting to the ED after a fall. Trial registration: This study was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12614000336684 (27 March 2014).

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U2 - 10.1186/s12913-017-2520-9

DO - 10.1186/s12913-017-2520-9

M3 - Article

VL - 17

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

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