ArticleBMC health services research2017
The Health Literacy Questionnaire (HLQ) at the patient-clinician interface: a qualitative study of what patients and clinicians mean by their HLQ scores.
Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
68 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Agreement between Patients' and Healthcare Professionals' Assessment of Patients' Health Literacy-A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Translation and cultural adaptation of the health literacy questionnaire (HLQ) in Morocco.Journal of patient-reported outcomes · 2026Article
- The argument-based approach to validity: theory, assumptions, evidence, and consequences.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Developing a validity testing plan for a patient-reported outcome measure in a new context using the argument-based approach to validity.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Strengthening health literacy among urban marginalised populations through a tailored primary care model: a mixed-methods study.BMC primary care · 2026Article
- Caregiver perceptions of healthcare barriers across traditional and digital contexts: a mixed-methods analysis.NPJ digital medicine · 2025Article
- Health literacy strengths and challenges of Australian smokers: a cluster analysis.Health promotion international · 2025Article
- Using cluster analysis to identify the health literacy strengths and challenges of people living with motor neurone disease in Australia.BMC health services research · 2025Article
- Development and evaluation of the patient engagement questionnaire (PEQ).PEC innovation · 2025Article
- Creation of Text Vignettes Based on Patient-Reported Data to Facilitate a Better Understanding of the Patient Perspective: Design Study.JMIR human factors · 2025Article
- Psychometric properties of the health literacy questionnaire tested in Vietnamese adults with chronic diseases.BMC public health · 2025Article
- Health literacy and household financial loss on malaria treatment for children under five in Ghana: a patients' perspective.International health · 2025Article
- Article
- Measuring Alliance and Symptom Severity in Psychotherapy Transcripts Using Bert Topic Modeling.Administration and policy in mental health · 2024Article
- Attitudes towards risk-stratified breast cancer screening: a population-based survey among 5,001 Danish women.BMC cancer · 2024Article
- Article
- Health literacy of rheumatology patients in three clinics in Australia and its association with sociodemographic and clinical characteristics.Rheumatology advances in practice · 2024Article
- Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review.Healthcare (Basel, Switzerland) · 2023Article
- The Intersection of Health Literacy and Public Health: A Machine Learning-Enhanced Bibliometric Investigation.International journal of environmental research and public health · 2023Article
- Individual and environmental determinants associated with longer times to access pediatric rheumatology centers for patients with juvenile idiopathic arthritis, a JIR cohort study.Pediatric rheumatology online journal · 2023Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Health Literacy Questionnaire (HLQ) has nine scales that each measure an aspect of the multidimensional construct of health literacy. All scales have good psychometric properties. However, it is the interpretations of data within contexts that must be proven valid, not just the psychometric properties of a measurement instrument. The purpose of this study was to establish the extent of concordance and discordance between individual patient and clinician interpretations of HLQ data in the context of complex case management.
methodsSixteen patients with complex needs completed the HLQ and were interviewed to discuss the reasons for their answers. Also, the clinicians of each of these patients completed the HLQ about their patient, and were interviewed to discuss the reasons for their answers. Thematic analysis of HLQ scores and interview data determined the extent of concordance between patient and clinician HLQ responses, and the reasons for discordance.
resultsHighest concordance (80%) between patient and clinician item-response pairs was seen in Scale 1 and highest discordance (56%) was seen in Scale 6. Four themes were identified to explain discordance: 1) Technical or literal meaning of specific words; 2) Patients' changing or evolving circumstances; 3) Different expectations and criteria for assigning HLQ scores; and 4) Different perspectives about a patient's reliance on healthcare providers.
conclusionThis study shows that the HLQ can act as an adjunct to clinical practice to help clinicians understand a patient's health literacy challenges and strengths early in a clinical encounter. Importantly, clinicians can use the HLQ to detect differences between their own perspectives about a patient's health literacy and the patient's perspective, and to initiate discussion to explore this. Provision of training to better detect these differences may assist clinicians to provide improved care. The outcomes of this study contribute to the growing body of international validation evidence about the use of the HLQ in different contexts. More specifically, this study has shown that the HLQ has measurement veracity at the patient and clinician level and may support clinicians to understand patients' health literacy and enable a deeper engagement with healthcare services.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.