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BMC Medical Research Methodology
Published in: BMC Medical Research Methodology 1/2019

Open Access 01-12-2019 | Research article

Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis

Authors: A. J. Woudstra, C. S. Meppelink, H. Pander Maat, J. Oosterhaven, M. P. Fransen, A. L. Dima

Published in: BMC Medical Research Methodology | Issue 1/2019

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Abstract

Background

Accurate measurement of health literacy is essential to improve accessibility and effectiveness of health care and prevention. One measure frequently applied in international research is the Short Assessment of Health Literacy (SAHL). While the Dutch SAHL (SAHL-D) has proven to be valid and reliable, its administration is time consuming and burdensome for participants. Our aim was to further validate, strengthen and shorten the SAHL-D using Rasch analysis.

Methods

Available cross-sectional SAHL-D data was used from adult samples (N = 1231) to assess unidimensionality, local independence, item fit, person fit, item hierarchy, scale targeting, precision (person reliability and person separation), and presence of differential item functioning (DIF) depending on age, gender, education and study sample.

Results

Thirteen items for a short form were selected based on item fit and DIF, and scale properties were compared between the two forms. The long form had several items with DIF for age, gender, educational level and study sample. Both forms showed lower measurement precision at higher health literacy levels.

Conclusions

The findings support the validity and reliability of the SAHL-D for the long form and the short form, which can be used for a rapid assessment of health literacy in research and clinical practice.
Appendix
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Metadata
Title
Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis
Authors
A. J. Woudstra
C. S. Meppelink
H. Pander Maat
J. Oosterhaven
M. P. Fransen
A. L. Dima
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Medical Research Methodology / Issue 1/2019
Electronic ISSN: 1471-2288
DOI
https://doi.org/10.1186/s12874-019-0762-4

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