Journal of Health Literacy

Journal of Health Literacy

Development and Validation of a Tool for Measuring Health-Related Media Literacy (HRML) Among Adolescents and Adults

Articles in Press

Document Type : Original Article

Authors
Kimiya Izady 1
Narges Roustaei 2
Mohsen Shams 3, 4
Saadat Parhizkar 5
Mostafa Maleki 6
1 M.Sc. in Health Education and Promotion, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran.
2 Associate Professor, Ph.D. in Biostatistics, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
3 Professor, Ph.D. in Health Education, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
4 Professor, Ph.D. in Health Education, Department of Health Education and Promotion, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
5 Associate Professor, Ph.D. in Reproductive Health, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran.
6 Assistant Professor, Ph.D. in Health Education and promotion, Department of Public Health, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
10.22038/jhl.2025.91300.1863
Abstract
Background and Objectives: With the proliferation of media platforms as primary sources of health information, evaluating individuals' ability to effectively use these resources is crucial. This study aimed to develop and validate a reliable and valid assessment tool for measuring HRML.

Materials and Methods: The study was conducted in 2023, which involved two phases: tool development and validation. An initial draft of the HRML assessment tool was created, encompassing items assessing four key skill domains: Search and Acquire, Understanding, Appraisal, and Applying. Face and content validity were assessed through expert review by 13 health professionals familiar with health and media literacy. Exploratory factor analysis (EFA) was used to examine the interrelationships among the four dimensions and establish item-domain relationships. Confirmatory factor analysis (CFA) evaluated model fit. Reliability was assessed by administering the questionnaire to 203 healthcare service users in Boyer-Ahmad County, and internal consistency was determined using Cronbach's alpha.  

Results: The final questionnaire comprised 28 items across four domains of skills: searching and acquiring, understanding, appraising, and applying. The average content validity ratio (CVR) was 0.889, and the average content validity index (CVI) was 0.991. All four HRML dimensions showed significant positive correlations (p < 0.01). CFA indicated acceptable model fit (CMIN/DF = 1.43, AGFI = 0.830, RMSEA = 0.040, CFI = 0.903, IFI = 0.905). Cronbach's alpha for the overall scale was 0.820.

Conclusion: Effective health communication is crucial for the success of health interventions. This validated HRML assessment tool can identify areas for improvement in individuals' media literacy skills and determine preferred media sources. This information can inform the development of targeted interventions to promote informed health decision-making in individuals and communities. The tool is suitable for use in various settings, including educational institutions, workplaces, service centers, and community spaces.
Keywords
Development and Validation
Health Literacy
Media Literacy
Questionnaire

Acknowledgements: The authors acknowledge the generous financial support of Yasuj University of Medical Sciences, Yasuj, Iran.


Availability of Data and Materials: The data set used in this study will be available based on a reasoned request.


Conflicts of interest: None declared.


Consent for publication: Not applicable. 


Ethical Approval and consent to participate: This research adhered to the ethical principles outlined in the Declaration of Helsinki for studies involving human subjects. The study involved analysis of social experiences through participant interviews, with no procedures conducted on human tissues. Informed consent was obtained from all participants prior to data collection. This study received ethical approval from the Ethics Committee of Yasuj University of Medical Sciences (ethical code: IR.YUMS.REC.1400.202).


Funding: Financial support was provided by Yasuj University of Medical Sciences, Yasuj, Iran. 


Author Contributions: Performance of data gathering: M, Sh, and K, E; Planning and supervision of the work: M, Sh; K, E; Performance of the analysis: S, P, and N, R; Manuscript draft: K, E, and M, M; and comment on the final manuscript: all authors. All authors have reviewed the final manuscript. All authors have read and accepted the published version of the manuscript. 

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/

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Journal of Health Literacy

Articles in Press, Accepted Manuscript
Available Online from 23 December 2025