The Health Literacy Measure for Adolescents (HELMA): Development and psychometric evaluation

Health literacy usually refers to personal competencies for access to, process and use of health information and services to make sound decisions and maintain good health. The aim of this study was to develop and evaluate the psychometric properties of Health Literacy Measure for Adolescents (HELMA).
This study consisted of two qualitative and quantitative phases. In the qualitative part, in-depth interviews with 67 adolescents aged 15-18 were performed to generate initial item pool. Then content validity and face validity of items were assessed through expert panel review and interview with adolescents. In quantitative part, to describe psychometric properties of the scale, validity, reliability (internal consistency and test-retest) and factor analysis were assessed.
In qualitative stage, an item pool with 104 items was generated which after content validity decreased to 47 items. In quantitative part, 582 adolescents aged 15-18 participated in the study with mean age 16.2 year. 51.2% of participants were females. In principal component factor analysis, 8 factors loaded that accounted for 55.06% of observed variance. Reliability has been approved by α=0.93 and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (ICC=0.93). Final questionnaire had been approved with 44 items in eight domains of gain access to, reading, understanding, appraise, use, communication, self- efficacy and numeracy.
The Health Literacy Measure for Adolescents (HELMA) is a valid and reliable instrument for measuring health literacy of adolescents aged 15-18 that can evaluate different level of functional, interactive and critical health literacy in adolescents.