Health Literacy for Iranian Adults (HELIA): development and psychometric properties

Objective (s): Health literacy has been defined as ‘the degree to which individuals have the capacity to obtain، process and understand basic health information and services needed to make basic health decisions’. This study aimed to develop and psychometrically evaluate a measure for health literacy in Iranian adults. A review of literature on all measures of health literacy was conducted in order to generate an item pool. Then، based on a definition of health literacy and the most important public health issues in Iran، a framework was identified in order to develop the initial questionnaire. The initial questionnaire contained 66 items. Accordingly 15 specialists from different disciplines were approached to carry out content validity. Consequently 19 items were removed and a provisional version of the questionnaire with 47 items was provided. Finally، a random sample of adults living in Tehran completed the questionnaire. Psychometric properties of the instrument were assessed performing exploratory factor analysis and internal consistency. In all 336 adults aged 18 to 65 years old completed the questionnaire. When performed the exploratory factor analysis، 33 items were loaded indicating a 5-factor solution for the questionnaire namely: access (6 items)، reading (4 items)، understanding (7 items)، appraisal (4 items)، and decision (12 items) that jointly explained %53. 2 of variance observed. Additional analysis for internal consistency showed satisfactory results with Cronbach’s alpha coefficients ranging from 0. 72 to 0. 89. The findings suggest that the Health Literacy for Iranian Adults (HELIA) is a reliable and valid instrument for measuring health literacy in Iran.