Development and initial validation of a computer-administered health literacy assessment in Spanish and English: FLIGHT/VIDAS.

Current measures of health literacy have been criticized on a number of grounds, including use of a limited range of content, development on small and atypical patient groups, and poor psychometric characteristics. In this paper, we report the development and preliminary validation of a new computer-administered and -scored health literacy measure addressing these limitations. Items in the measure reflect a wide range of content related to health promotion and maintenance as well as care for diseases. The development process has focused on creating a measure that will be useful in both Spanish and English, while not requiring substantial time for clinician training and individual administration and scoring. The items incorporate several formats, including questions based on brief videos, which allow for the assessment of listening comprehension and the skills related to obtaining information on the Internet. In this paper, we report the interim analyses detailing the initial development and pilot testing of the items (phase 1 of the project) in groups of Spanish and English speakers. We then describe phase 2, which included a second round of testing of the items, in new groups of Spanish and English speakers, and evaluation of the new measure’s reliability and validity in relation to other measures. Data are presented that show that four scales (general health literacy, numeracy, conceptual knowledge, and listening comprehension), developed through a process of item and factor analyses, have significant relations to existing measures of health literacy.

健康素养的现行衡量标准在多个方面受到了批评，包括使用的内容范围有限、基于小型且非典型的患者群体进行开发以及心理测量特征不佳。在本文中，我们报告了一种新的计算机施测和计分的健康素养衡量标准的开发及初步验证情况，该标准旨在解决这些局限性。该衡量标准中的项目反映了与健康促进、维护以及疾病护理相关的广泛内容。开发过程侧重于创建一种在西班牙语和英语中都有用的衡量标准，同时不需要临床医生花费大量时间进行培训以及个体施测和计分。这些项目包含多种形式，包括基于短视频的问题，从而能够评估听力理解以及与在互联网上获取信息相关的技能。在本文中，我们报告了详细阐述项目初步开发和试点测试（项目的第一阶段）的中期分析，测试对象为说西班牙语和英语的群体。然后我们描述了第二阶段，包括在新的说西班牙语和英语的群体中对项目进行第二轮测试，以及评估新衡量标准相对于其他标准的信度和效度。所呈现的数据表明，通过项目和因素分析过程开发的四个量表（总体健康素养、计算能力、概念知识和听力理解）与现有的健康素养衡量标准具有显著的相关性。