Validation and Reliability of the Health Literacy Organization Checklist

Document Type : Original Article

Authors

1 Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Social Determinant of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Student Research Committee. Mashhad University of Medical Sciences, Mashhad, Iran.

4 Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background and Objectives: Health literacy organizations are doing a series of things in a health and healing environment to bring that environment to a level that makes it easier for people to understand and interpret health information. These items are designed in the checklist of Health Literacy Organization, so this study was conducted with the aim of validating the checklist of Health Literacy Organization in Iran.

Materials and Methods: This research was a cross-sectional descriptive analytic study that was conducted on the tool of the Health Literacy Organization that was designed during previous studies. First, the face validity assessment of the checklist was checked by 22 experts. Then, the content validity was done using the relative coefficient of content validity rate and the content validity index by 22 experts in the field of health literacy who have favorable clinical and technical university experiences. In the third stage, in order to evaluate the calculation of the reliability coefficient, the instrument was performed by two evaluators in 12 environments, including three hospitals, two clinics, five comprehensive health service centers and two pharmacies.

Results: During the content validity phase, 6 questions were removed from the list of 67 questions, and 3 questions were structurally modified. The questionnaire had a CVI of 0.919 and a CVR of 0.781. The score of the reliability coefficient for the checklist was 0.94, and if this index is higher than 0.8, it indicates a very favorable reliability. Ultimately, the checklist of 10 attributes and 61 questions was approved.

Conclusion: The evaluation checklist of Health Literacy Organization has the necessary psychometric features. Hence, it is suggested to use this tool, which is a native tool and has been prepared during various studies in Iran, to design and measure the organization of health literacy.

Keywords


Acknowledgements: The authors are grateful to all who participated in this study.


Availability of data and materials: The data sets used and/or analyzed during the current study was available from the corresponding author on reasonable request.


Conflict of interests: The authors declared no conflict of interest


Consent for publication: Not applicable


Ethical approval and consent to participate: All procedures comply with the principles of the Declaration of Helsinki. Ethical issues (Including plagiarism, informed consent, misconduct, data fabrication and/or falsification, double publication and/or submission, redundancy, etc.) have been completely observed by the authors. This article is the result of a research project with code 4002022 and ethics code IR.MUMS.FHMPM.REC.1401.033.


Funding: The study was supported financially by Mashhad University of Medical Science.


Author contributions: N.P. designed the work, E.Ch.Kh. and M.N. implemented the work, E.Ch.Kh. and J.J. analyzed and interpreted the data, E.Ch.Kh. and S.B.T.S. writing the manuscript.

1. Charoghchian Khorasani E, Peyman N, Esmaily H. Effect of education based on the theory of self-efficacy and health literacy strategies on exclusive breastfeeding: A randomized clinical trial. Koomesh. 2019;21(4):633-8.
2. Delavar F, Pashaeypoor S, Negarandeh R. Health literacy index: A new tool for health literacy assessment. Journal of Hayat. 2018;24(1):1-6.    
3. Mahmoodi H NH, Moradzadeh R, Shahi F, Azimi S, ShirzadiSh, Sharifi Saqqezi P, Keshavarzian Kh, Iranpour A, Saadati F, Hosking S, Pirehbabi K, Behboodi L, Bhalla D. I . Spring 2023    
 8(1): 28-41. nadequate functional health literacy and its associated gender inequality among an ethnic population: A social survey. Journal of Health Literacy. 2023;8(1):28-41.    
 4. Berkman ND, Davis TC, McCormack L. Health literacy: what is it? Journal of health communication. 2010;15(S2):9-19. https://doi.org/10.1080/10810730.2010.499985 PMid:20845189    
 5. Charoghchian Khorasani E, Jafari A, Mahdiadeh M, Tehrani H, Moghzi M, Peyman N. Designing a model of health literacy organization in health care centers in Iran. Journal of Health Literacy. 2023;7(4):44-59.    
 6. Safety ACo, Care QiH. Health literacy: taking action to improve safety and quality: Australian Commission on Safety and Quality in Health Care; 2015.    
 7. Groene RO, Rudd RE. Results of a feasibility study to assess the health literacy environment: navigation, written, and oral communication in 10 hospitals in Catalonia, Spain. Journal of Communication in Healthcare. 2011;4(4):227-37. https://doi.org/10.1179/1753807611Y.0000000005
8. Rudd RE. Needed action in health literacy. Journal of Health Psychology. 2013;18(8):1004-10. https://doi.org/10.1177/1359105312470128 PMid:23349399    
9. Brega AG, Hamer MK, Albright K, Brach C, Saliba D, Abbey D, et al. Organizational health literacy: Quality improvement measures with expert consensus. HLRP: Health Literacy Research and Practice. 2019;3(2):e127-e46. https://doi.org/10.3928/24748307-20190503-01 PMid:31294314 PMCid:PMC6610031    
 10. Baker DW. The meaning and the measure of health literacy. J Gen Intern Med. 2006;21:878-83. https://doi.org/10.1111/j.1525-1497.2006.00540.x PMid:16881951 PMCid:PMC1831571    
 11. Brach CK, D.; Hernandez, L.M.; Baur, C.; Parker, R.; Dreyer, B.; Schyve, P.; Lemerise, A.J.; Schillinger, D. Agency for Healthcare Research and Quality. Ten Attributes of Health Literate Health Care Organizations; NAM Perspectives: Washington, DC,USA,. 2012:1-26. https://doi.org/10.31478/201201f
12. Charoghchian Khorasani E, Tavakoly Sany SB, Mahdizadeh M, Doosti H, Tehrani H, Moghzi M, et al. Attributes of Organizational Health Literacy in Health Care Centers in Iran: A Qualitative Content Analysis Study. International Journal of Environmental Research and Public Health. 2022;19(4):2310. https://doi.org/10.3390/ijerph19042310 PMid:35206492 PMCid:PMC8872005    
13. Charoghchian Khorasani E, Tavakoly Sany SB, Tehrani H, Doosti H, Peyman N. Review of organizational health literacy practice at health care centers: outcomes, barriers and facilitators. International journal of environmental research and public health. 2020;17(20):7544. https://doi.org/10.3390/ijerph17207544 PMid:33081335 PMCid:PMC7589923    
 14. Polit DF YF. Measurement and the Measurement of Change: A Primer for the Health Professions. Philadelphia, PA: Wolters Kluwer. 2016.    
 15. Annarumma C PR CM. Who empowers whom? The role of organizational health literacy in empowering patients. Sinergie. 2017;104((Sep-Dec)). https://doi.org/10.7433/s104.2017.01
16. Hayran O OA, Ö. O. Assessment of Organizational Health Literacy in a Group of Public, Private and University Hospitals in Istanbul. Journal of Health Systems and Policies. 2019;1(1):47-59.    
17. Kowalski C LS-Y, Schmidt A, Wesselmann S, Wirtz MA, Pfaff H, et al. . The health literate health care organization 10 item questionnaire (HLHO-10): development and validation. . BMC Health Serv Res 2015;15(1):1-9. https://doi.org/10.1186/s12913-014-0652-8 PMid:25603697 PMCid:PMC4307186    
 18. Abrams MA K-R, S., Riffenburgh, A., & Savage, B. Building health literate organizations: A guidebook to achieving organizational change. Des Moines, IA: Wellmark Foundation. Retrieved from http://www.unitypoint.org/health-literacyguidebook.aspx2014.    
 19. RJ. A. mproving health outcomes with better patient understanding and education. Risk Management and Health Policy. 2010;3:61-72. https://doi.org/10.2147/RMHP.S7500 PMid:22312219 PMCid:PMC3270921    
 20. Ernstmann N HS, Kowalski C, Pfaff H, Ansmann LJZfE. Fortbildung und Qualität im Gesundheitswesen. Measuring attributes of health literate health care organizations from the patients' perspective: Development and validation of a questionnaire to assess health literacysensitive communication (HL-COM). . Zeitschrift Fur Evidenz Fortbildung Und Qualitaet Im Gesundheitswesen. 2017;121:58-63. https://doi.org/10.1016/j.zefq.2016.12.008 PMid:28545615    
 21. Trezona A DS, Osborne RHJBhsr.. 2018;18(1):1-10. Development of the Organisational Health Literacy Responsiveness (Org-HLR) self-assessment tool and process. . BMC Health Services Research. 2018;18(1):1-10. https://doi.org/10.1186/s12913-017-2770-6 PMid:29291745 PMCid:PMC5748943    
 22. CfDCaP. C. Federal plain language guidelines. Atlanta, GA; U.S. Department of Health and Human Services. Retrieved from http://www.plainlanguage.gov/ 2011.    
 23. Brega AG HM, Albright K, Brach C, Saliba D, Abbey D, et al. . Organizational health literacy: Quality improvement measures with expert consensus. . Health Literacy Research and Practice. 2019;3(2):e127-e46. https://doi.org/10.3928/24748307-20190503-01 PMid:31294314 PMCid:PMC6610031    
 24. Brach C KD, Hernandez LM, Baur C, Parker R, Dreyer B, et al. . Ten attributes of health literate health care organizations. 2012. https://doi.org/10.31478/201206a
25. Ryan L L, M., McGill, S., Stikes, R., Senior, B., Helinger, B., . . . Davis, D. . Evaluation of printed health education materials for use by low-education families. ournal of Nursing Scholarship. 2014;46:218-28. https://doi.org/10.1111/jnu.12076 PMid:24597957    
26. Wynia MK OC. Health literacy and communication quality in health care organizations. Journal of health communication. 2010;15(52):102-15. https://doi.org/10.1080/10810730.2010.499981 PMid:20845197 PMCid:PMC3086818    
 27. Wieczorek CC GK, Dietscher CJHHLR. Improving organizational health literacy in extracurricular youth work settings. Health literacy research and practice. Practice. 2017;1(4):e233-e8. https://doi.org/10.3928/24748307-20171101-01 PMid:31294268 PMCid:PMC6607790    
 28. Cormier CM K, J.W.. . 2009;48:. Health literacy knowledge and experiences of senior baccalaureate nursing students. Journal of Nursing Education. 2009;48:237-48. https://doi.org/10.3928/01484834-20090416-02 PMid:19476028    
 29. V. M-J. A systematic review of the literature on health literacy in nursing education. Nurse Educator. 2016;41(2):93-7. https://doi.org/10.1097/NNE.0000000000000204 PMid:26237008    
 30. N. B. Organizational behavior in health care (2nd ed.): Sudbury, MA: Jones and Bartlett Publishers.; 2011.    
 31. Brach C D, B.P., & Schillinger, D. Physicians' role in creating health literate organizations: A call to action. Journal of General Internal Medicine. 2013;29:273-5. https://doi.org/10.1007/s11606-013-2619-6 PMid:24113805 PMCid:PMC3912273    
 32. Kaphingst KA W, N. L., Wray, R. J., Brown, M. L., Buskirk, T., & Kreuter, M. W. . Effects of patient health literacy, patient engagement and a system-level health literacy attribute on patient-reported outcomes: A representative statewide survey. BMC Health Services Research. 2014;14:475. https://doi.org/10.1186/1472-6963-14-475 PMid:25288179 PMCid:PMC4282193    
 33. Koh HK B, C., Harris, L. M., & Parchman, M. L. . A proposed "health literate care model' would constitute a systems approach to improving patients" engagement in care. Health Affairs. 2013;32:357-67. https://doi.org/10.1377/hlthaff.2012.1205 PMid:23381529 PMCid:PMC5102011    
 34. DeWalt DA C, L.F., Hawk, V.H., Broucksou, K.A., & Hink, A. . . Health literacy universal precautions toolkit. Rockville, MD: U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. 2010. https://doi.org/10.1016/j.outlook.2010.12.002 PMid:21402204 PMCid:PMC5091930    
 35. Somers SA M, R. . Health literacy implications of the Affordable Care Act. Washington, DC: Center for Health Care Strategies, Inc 2010.    
 36. L. P. Assessing Organizational Health Literacy at an academic health center: A quantitative research study: University of Arkansas; 2017.    
 37. Eichler K W, S., & Brugger, U. The costs of limited health literacy: A systematic review. International Journal of Public Health. 2009;54(5):313-24. https://doi.org/10.1007/s00038-009-0058-2 PMid:19644651 PMCid:PMC3785182.