Testing health literacy skills in older Korean adults

Objective: The purpose of this study was to develop a valid and reliable screening test for limited health literacy for older Korean adults. Methods: A pool of 102 items was generated based on empirical referents, which, after expert review, field study, and content validity, was reduced to 29 items with three subscales. Construct validity and reliability were established using a convenience sample of 411 community dwelling elderly participants and exploratory factor analysis, and Cronbach's alpha was employed. Rasch analysis was also performed to assess the unidimensionality of the construct and item adequacy. Results: Rasch analysis showed that the scale was unidimensional and the majority of the items demonstrated good fit. The final instrument, the Korean Health Literacy Scale (KHLS), is a 24-item questionnaire containing short passages, pictures, and graphs with multiple-choice answer format, with an internal consistency of .891. There are 13 comprehension and numeracy questions and I I questions about health-related terms; the test requires 15-20 min for administration. Conclusion: KHLS is culturally suitable as a screening test for limited literacy for older Korean adults in the community. Practice Implications: Korean-investigators now have a validated health literacy tool for research with elderly participants. (C) 2009 Elsevier Ireland Ltd. All rights reserved.