ArticleBMJ open2020
Psychometric properties of an Arabic-language health literacy assessment scale for adolescents (HAS-A-AR) in Palestine.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021.PloS one · 2022Pooled it
- Methodological quality of health literacy instruments used among school children in Asian countries: a systematic review.Journal of pharmaceutical policy and practice · 2026Review
- Self-Care behaviors and their association with self-efficacy and health literacy among adolescents with type 1 diabetes mellitus in palestine: a cross-sectional study.BMC psychology · 2025Article
- Health literacy mediating the association between health information sources and oral health knowledge among Palestinian adolescent refugees: a cross-sectional study.BMC oral health · 2025Article
- Exposure to violence and other determinants of health literacy among Palestinian adolescents: a cross-sectional study.BMC public health · 2024Article
- Measuring adolescent health literacy in Taiwan: validation of the health literacy assessment scale for adolescents.BMC public health · 2023Article
- Health literacy among adolescents and young adults in the Eastern Mediterranean region: a scoping review.BMJ open · 2023Article
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Abstract
objectivesHealth literacy research in Palestine is limited, and a locally validated tool for use among adolescents has been unavailable until now. Therefore, this study aimed to adapt health literacy assessment scale for adolescents (HAS-A) into Arabic language (HAS-A-AR) and Palestinian context and to investigate its psychometric properties.
designWe conducted a cross-sectional household survey using a stratified random sample and household face-to-face interviews. SETTING AND
participantsWe conducted 1200 interviews with sixth to ninth graders in the Ramallah and al-Bireh district of the West Bank, Palestine in 2017.
methodsWe translated and adapted HAS-A to be sensitive to the Palestinian context and tested its psychometric properties. We evaluated face and content validity during the back-translation process and checked for construct validity through exploratory factor analysis (EFA). We tested for internal consistency using Cronbach's alpha, MacDonald's omega test and the greatest lower bound (GLB). Furthermore, we calculated the scale's average inter-item correlation.
resultsEFA revealed that HAS-A-AR has a similar structure to the original HAS-A. It extracted three factors (communication, confusion and functional health literacy) whose eigenvalues were >1. Together they explained 57% of the total variance. The proportions of adolescents with high levels of communication, confusion and functional health literacy were 45%, 68% and 80%, respectively. Cronbach's alpha, MacDonald's omega and the GLB values for communication subscale were 0.87, 0.88 and 0.90, and they were 0.78, 0.77 and 0.79 for confusion subscale, while they were 0.77, 0.77 and 0.80, respectively, for functional healthy literacy subscale. The average inter-item correlation for the subscales ranged between 0.36 and 0.59.
conclusionHAS-A-AR is a valid and reliable health literacy measuring instrument with appropriate psychometric properties. HAS-A-AR is currently available for use among adolescents in Palestine and the surrounding Arab countries with similar characteristics as Palestine, including language, culture and political instability.
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