ArticleFrontiers in public health2023
Development and validation of the health literacy environment scale for Chinese hospitals from patients' perspective.
Article in Frontiers in public health, 2023. 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.
- Defining, assessing, and implementing organizational health literacy: barriers, facilitators, and tools - a systematic review.BMC health services research · 2025Pooled it
- Development and initial validation of a modular life-course health education and science communication needs scale for Chinese clinical and community service users: a Tianjin-based study.Frontiers in public health · 2026Article
- Sinicization and psychometric validation of the German Pelvic Floor Questionnaire for Pregnant and Postpartum Women.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2025Article
- A new health literacy scale for staff in preschool childcare institution: development and preliminary validation.BMC public health · 2025Article
- A Health Literate Healthcare Organization Index System for China: Based on CiteSpace and Qualitative Analysis.Journal of multidisciplinary healthcare · 2025Article
- Conceptual Framework of Health-Literate Nursing System: A Proceduralized Grounded Theory Approach.Journal of nursing management · 2025Article
- Fine-Tuned Bidirectional Encoder Representations From Transformers Versus ChatGPT for Text-Based Outpatient Department Recommendation: Comparative Study.JMIR formative research · 2024Article
- The Construction Level of Health Literate Health Organizations and Its Impact on Patients' Health Literacy: Based on Self-Determination Theory and Structural Equation Modeling.Inquiry : a journal of medical care organization, provision and financingArticle
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9 authors.
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Abstract
Introduction: While the research on improving individual health literacy by promoting individual skills and abilities is increasing, less attention has been paid to the complexities of the healthcare environment that may influence patients' ability to access, understand, and apply health information and health services to make health decisions. This study aimed to develop and validate a Health Literacy Environment Scale (HLES) that is suitable for Chinese culture. Methods: This study was conducted in two phases. First, using the Person-Centered Care (PCC) framework as a theoretical framework, initial items were developed by using the existing health literacy environment (HLE) related measurement tools, literature review, qualitative interviews, and the researcher's clinical experience. Second, scale development was based on two rounds of Delphi expert consultation and a pre-test conducted with 20 hospitalized patients. Using 697 hospitalized patients from three sample hospitals, the initial scale was developed after item screening and its reliability and validity were evaluated. Results: The HLES comprised 30 items classified into three dimensions as follows: interpersonal (11 items), clinical (9 items), and structural (10 items) dimensions. The Cronbach's α coefficient of the HLES was 0.960 and the intra-class correlation coefficient was 0.844. The confirmatory factor analysis verified the three-factor model after allowing for the correlation of five pairs of error terms. The goodness-of-fit indices signified a good fit for the model ( Conclusion: The HLES had good reliability and validity and provides a patient perspective tool for evaluating HLE and a new perspective for improving health literacy in China. That is, healthcare organizations make it easier for patients to access, understand, and use health information and service. Further studies about the validity and reliability of HLE should include other districts and different tiers or types of healthcare organizations.
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