Psychometric Evaluation of a 10-Item Health Insurance Knowledge Scale

J Nurs Meas. 2021 Dec 1;29(3):491-504. doi: 10.1891/JNM-D-20-00019. Epub 2021 Sep 13.

Abstract

Background: College students are a priority population for health insurance literacy interventions. Yet, there are few psychometric studies on measuring health insurance knowledge - a core construct of health insurance literacy.

Methods: We administered a health insurance survey to 2,250 college students. We applied Classical Test Theory and Item Response Theory methods to estimate psychometric properties of the Kaiser Family Foundation's 10-item health insurance knowledge quiz.

Results: The scale is unidimensional, and a two-parameter logistic model best fit the data. IRT estimates indicated varying item discriminations (a range: 0.717-2.578) and difficulties (b range: -0.913-1.790). Precision of measurement was maximized for students half a standard deviation below the mean (θ = -0.686) health insurance knowledge ability.

Conclusions: This scale can be used to identify gaps in health insurance knowledge among college students and be applied in clinical and community health education practice.

Keywords: Item Response Theory; college students; health insurance knowledge; health insurance literacy; young adults.

MeSH terms

  • Health Literacy*
  • Humans
  • Insurance, Health
  • Psychometrics / methods
  • Reproducibility of Results
  • Surveys and Questionnaires