Measuring health literacy regarding infectious respiratory diseases: a new skills-based instrument

PLoS One. 2013 May 28;8(5):e64153. doi: 10.1371/journal.pone.0064153. Print 2013.


Background: There is no special instrument to measure skills-based health literacy where it concerns infectious respiratory diseases. This study aimed to explore and evaluate a new skills-based instrument on health literacy regarding respiratory infectious diseases.

Methods: This instrument was designed to measure not only an individual's reading and numeracy ability, but also their oral communication ability and their ability to use the internet to seek information. Sixteen stimuli materials were selected to enable measurement of the skills, which were sourced from the WHO, China CDC, and Chinese Center of Health Education. The information involved the distribution of epidemics, immunization programs, early symptoms, means of disease prevention, individual's preventative behavior, use of medications and thermometers, treatment plans and the location of hospitals. Multi-stage stratified cluster sampling was employed to collect participants. Psychometric properties were used to evaluate the reliability and validity of the instrument.

Results: The overall degree of difficulty and discrimination of the instrument were 0.693 and 0.482 respectively. The instrument demonstrated good internal consistency reliability with a Cronbach's alpha of 0.864. As for validity, six factors were extracted from 30 items, which together explained 47.3% of the instrument's variance. And based on confirmatory factor analysis, the items were grouped into five subscales representing prose, document, quantitative, oral and internet based information seeking skills (χ(2) = 9.200, P>0.05, GFI = 0.998, TLI = 0.988, AGFI = 0.992, RMSEA = 0.028).

Conclusion: The new instrument has good reliability and validity, and it could be used to assess the health literacy regarding respiratory infectious disease status of different groups.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Clinical Competence*
  • Educational Measurement / methods*
  • Factor Analysis, Statistical
  • Female
  • Health Literacy / methods*
  • Humans
  • Male
  • Middle Aged
  • Psychometrics
  • ROC Curve
  • Reproducibility of Results
  • Respiratory Tract Diseases / diagnosis*
  • Social Discrimination
  • Surveys and Questionnaires
  • Young Adult

Grant support

This study was funded by China-US Collaborative Program on Emerging and Re-emerging Infectious Diseases (5U2GGHH000018-02). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.