ArticleBMC public health2023
Validity and reliability of the swedish versions of the HLS-EU-Q16 and HLS-EU-Q6 questionnaires.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 29 citations in OpenAlex.
- A cross-sectional study of health literacy and health behaviors among adults in South Korea: findings from a principal component analysis.BMC public health · 2026Article
- Measuring eHealth Literacy in the European Economic Area, Switzerland, and the United Kingdom: Scoping Review.Journal of medical Internet research · 2026Article
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- Health equity through health literacy: validating HLSBMC public health · 2026Article
- Measuring health literacy among older inpatients after elective surgery: evaluation of the European Health Literacy Survey Questionnaire-short form (HLS-EU-Q16).Frontiers in psychology · 2026Article
- Psychometric validation of the Spanish HLS-EU-Q16 in Ecuador: evidence for health literacy assessment and public health education.Frontiers in public health · 2026Article
- Understanding Loneliness as a Preventive Health Priority Among Men: Findings From an Australian Population Survey.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2025Article
- Rasch analysis of the mobile version of the eHealth literacy scale for cardiovascular disease patients.Scientific reports · 2025Article
- Impact of health literacy and general self-efficacy on surgical outcomes 2 years after bariatric surgery.Clinical obesity · 2025Article
- Validation of the Swedish version of HLS19-Q12: a measurement for general health literacy.Health promotion international · 2025Article
- Article
- Stroke survivors' health literacy is not associated with caregiver burden: a cross-sectional study.Scientific reports · 2025Article
- The association between health literacy, private health insurance, and medical expenditure in South Korea.BMC health services research · 2025Article
- Development and assessment of the health-related quality of life scale for children with hearing loss in China.BMC public health · 2025Article
- Effectiveness ofBMJ open · 2025Article
- Association between general self-efficacy and health literacy among stroke survivors 1-year post-discharge: a cross-sectional study.Scientific reports · 2024Article
- Health literacy in individuals with knee pain-a mixed methods study.BMC public health · 2023Article
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Authors and funding
5 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth Literacy is a crucial factor for health. In Europe, many people have limited health literacy (i.e. difficulties with accessing, understanding, appraising and using health information). This study aimed to evaluate the psychometrics of the Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6, instruments that aims to assess health literacy.
methodsIn this prospective psychometric study convenience sampling was used, which gave a study population of 347 Swedish-speaking adults. The psychometric evaluation included item distributional statistics, construct validity testing, and principal component analysis to assess structural validity. Internal consistency and test-retest reliability was also investigated.
resultsFor the Swedish version of HLS-EU-Q16, no floor effects were detected but a ceiling effect was noted among 28% of the respondents. Construct validity was supported as four out of five expected correlations was confirmed (educational level, self-perceived health, electronic health literacy and HLS-EU-Q6). In terms of structural validity, the principal component analysis yielded a four-factor structure with most items loading significantly only to one factor. The Swedish version of HLS-EU-Q16 had acceptable internal consistency (Cronbach's α = 0.89, split-half reliability = 0.93) and test-retest reliability showed stability over time (Cohen's κ = 0.822). For the Swedish version of HLS-EU-Q6, neither floor nor ceiling effects were observed. Construct validity was supported as HLS-EU-Q6 correlated as our a priori stated hypothesis. The principal component analysis did not support the unidimensionality of the scale as a two-factor structure was identified. The Swedish version of HLS-EU-Q6 had acceptable internal consistency (Cronbach's α = 0.77, split-half reliability = 0.80) and test-retest reliability showed stability over time (Cohen's κ = 0.812). According to the Swedish version of the HLS-EU-Q16, 71% of the participants were classified as having sufficient comprehensive health knowledge (CHL), while only 33% were classified as having this when the HLS-EU-Q6 was used.
conclusionsThe Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6 have acceptable psychometric properties, and based on the results we recommend its use to measure CHL. However, we are hesitant to use Sw-HLS-EU-Q6 in estimating different CHL levels and further studies need to be conducted to establish validity and accuracy of the thresholds of HLS-EU-Q6.
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