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BMC Pediatrics
Published in: BMC Pediatrics 1/2019

Open Access 01-12-2019 | Research article

Development and validation of a Chinese parental health literacy questionnaire for caregivers of children 0 to 3 years old

Authors: Yan Zhang, Mu Li, Hong Jiang, Huijing Shi, Biao Xu, Salla Atkins, Xu Qian

Published in: BMC Pediatrics | Issue 1/2019

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Abstract

Background

Given the limited information on parental health literacy measurements, the study aimed to develop and validate the Chinese Parental Health Literacy Questionnaire for caregivers of children 0 to 3 years old.

Methods

We conducted a validity and reliability study of the questionnaire through a cross-sectional survey and test-retest analysis respectively between March and April 2017. We recruited 807 caregivers of children 0 to 3 years old, among them 101 caregivers completed the test-retest assessment with 2 weeks interval. The reliability was determined by internal consistency, spilt-half reliability and test-retest reliability. The construct validity was assessed by confirmatory factor analysis.

Results

The 39-question Chinese Parental Health Literacy Questionnaire was demonstrated high internal consistency (Cronbach’s α = 0.89), spilt-half reliability (Spearman-Brown coefficient = 0.92) and test-retest reliability (Pearson correlation coefficient = 0.82). The confirmatory factor analysis showed that the construct of the questionnaire fitted well with the hypothetical model. The participants’ test scores of the Chinese Parental Health Literacy Questionnaire in the cross-sectional survey were positively associated with caregivers being mothers, more educated, the children with Shanghai Hukou, having only one child in the family, and higher family income.

Conclusion

The Chinese Parental Health Literacy Questionnaire demonstrated good reliability and validity, which could potentially be used as an effective evaluation instrument to assess parental health literacy.
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Literature
1.
2.
Britto PR, Lye SJ, Proulx K, Yousafzai AK, Matthews SG, Vaivada T, et al. Nurturing care: promoting early childhood development. Lancet. 2017;389(10064):91–102.CrossRef
3.
4.
Kickbusch I. Health literacy: the solid facts. Geneva: WHO Regional Office for Europe; 2013.
5.
6.
Kumar D, Sanders L, Perrin EM, Lokker N, Patterson B, Gunn V, et al. Parental understanding of infant health information: health literacy, numeracy, and the parental health literacy activities test (PHLAT). Acad Pediatr. 2010;10(5):309–16.CrossRef
7.
Nakamura D, Ogawa M, Nakamura T, Izawa KP. Impact of Parents' Comprehensive health literacy on BMI in children: a multicenter cross-sectional study in Japan. J Sch Health. 2018;88(12):910–6.CrossRef
8.
Harrington KF, Zhang B, Magruder T, Bailey WC, Gerald LB. The impact of Parent's health literacy on pediatric asthma outcomes. Pediatr Allergy Immunol Pulmonol. 2015;28(1):20–6.CrossRef
9.
Kilfoyle KA, Vitko M, O'conor R, Bailey SC. Health literacy and Women's reproductive health: a systematic review. J Women's Health (Larchmt). 2016;25(12):1237–55.CrossRef
10.
Yin HS, Dreyer BP, Foltin G, van Schaick L, Mendelsohn AL. Association of low caregiver health literacy with reported use of nonstandardized dosing instruments and lack of knowledge of weight-based dosing. Ambul Pediatr. 2007;7(4):292–8.CrossRef
11.
Sanders LM, Thompson VT, Wilkinson JD. Caregiver health literacy and the use of child health services. Pediatrics. 2007;119(1):e86–92.CrossRef
12.
Liechty JM, Saltzman JA, Musaad SM. Health literacy and parent attitudes about weight control for children. Appetite. 2015;91:200–8.CrossRef
13.
Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonskaand Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80.CrossRef
14.
Zhang Y, Jiang H, Shi HJ. Application of Delphi method to establish an evaluation system of health literacy of parents with children under 6 years old [in Chinese]. Matern Child Health Care Chin. 2017;32(23):5809–12.
15.
Sorensen K, Van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, et al. Measuring health literacy in populations: illuminating the design and development process of the European health literacy survey questionnaire (HLS-EU-Q). BMC Public Health. 2013;13:948.CrossRef
16.
Anthoine E, Moret L, Regnault A, Sebille V, Hardouin JB. Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures. Health Qual Life Outcomes. 2014;12:176.CrossRef
17.
Nunnally J, Bernstein I. Psychometric theory. 3rd ed. New York: McGraw-Hill; 1994.
18.
Kline TJB. Classical test theory: Assumptions, equations, limitations, and item analyses. In: Psychological testing: A practical approach to design and evaluation. Thousand Oaks: SAGE Publications, Inc; 2005. p. 91–107.
19.
Hawker GA, Davis AM, French MR, Cibere J, Jordan JM, March L, et al. Development and preliminary psychometric testing of a new OA pain measure--an OARSI/OMERACT initiative. Osteoarthr Cartil. 2008;16(4):409–14.CrossRef
20.
Lord FM. The relation of the reliability of multiple-choice tests to the distribution of item difficulties. Psychometrika. 1952;17(2):181–94.CrossRef
21.
Attali Y, Saldivia L, Jackson C, Schuppan F, Wanamaker W. Estimating item difficulty with comparative judgments. ETS Res Rep Ser. 2014;2014(2):1–8.
22.
Zhang WT, Dong W. Advanced SPSS statistical analysis [in Chinese], vol. 451. Beijing: Higher Education Press; 2013.
23.
Sakane Y, Yamaguchi M, Yokoi N, Uchino M, Dogru M, Oishi T, et al. Development and validation of the dry eye-related quality-of-life score questionnaire. JAMA Ophthalmol. 2013;131(10):1331–8.CrossRef
24.
Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16(3):297–3343.CrossRef
25.
George D, Mallery P. SPSS for windows step by step: a simple guide and reference 11.0 update (4th ed.). Boston: Allyn & Bacon; 2003.
26.
Chau PH, Leung AY, Li HL, Sea M, Chan R, Woo J. Development and validation of Chinese health literacy scale for low salt consumption-Hong Kong population (CHLSalt-HK). PLoS One. 2015;10(7):e0132303.CrossRef
27.
Osborne RH, Batterham RW, Elsworth GR, Hawkins M, Buchbinder R. The grounded psychometric development and initial validation of the health literacy questionnaire (HLQ). BMC Public Health. 2013;13:658.CrossRef
28.
Bentler PM, Bonett DG. Significance tests and goodness of fit in the analysis of covariance structures. Psychol Bull. 1980;88(3):588–606.CrossRef
29.
Schumacker R, Lomax R. A beginner's guide to structural equation modeling. 2nd ed. London: Lawrence Erlbaum Associates; 2004.CrossRef
30.
Nutbeam D. Defining and measuring health literacy: what can we learn from literacy studies? Int J Public Health. 2009;54(5):303–5.CrossRef
31.
Altin SV, Finke I, Kautz-Freimuth S, Stock S. The evolution of health literacy assessment tools: a systematic review. BMC Public Health. 2014;14:1207.CrossRef
32.
Kline RB. Principles and practices of structure equation modeling (3rd). New York: The Guilford Press; 2011.
33.
Duong TV, Aringazina A, Baisunova G. Nurjanah, Pham TV, Pham KM, et al. Measuring health literacy in Asia: validation of the HLS-EU-Q47 survey tool in six Asian countries. J Epidemiol. 2017;27(2):80–6.CrossRef
34.
Devellis WR. Scale Development: Theory and Applications [in Chinese]. Chongqing: Chongqing University Press; 2016. p. 218.
35.
Friedman D, Masek B, Barreto E, Baer L, Lapey A, Budgeand E, et al. Fathers and asthma care: paternal involvement, beliefs, and management skills. J Pediatr Psychol. 2015;40(8):768–80.CrossRef
36.
van der Heide I, Rademakers J, Schipper M, Droomers M, Sorensen K, Uiters E. Health literacy of Dutch adults: a cross sectional survey. BMC Public Health. 2013;13:179.CrossRef
37.
Sorensen K, Pelikan JM, Rothlin F, Ganahl K, Slonska Z, Doyle G, et al. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Pub Health. 2015;25(6):1053–8.CrossRef
38.
Ya-fei H, Run-jie C, Xin-feng P, Shen-bing G, Yuan D. Study on healthy literacy among 15-69-year-old residents of Shanghai City in 2012 [in Chinese]. Chin J Health Educ. 2015;2(31):151–4.
39.
Na J, Ji L, Guo-Wei Z, Ke-Li W, Hong-Bo C, Xu Q. Study on the current situation of basic child healthcare service utilization in a central urban area of Shanghai city [in chinses]. Matern Child Health Care Chin. 2013;35(28):5757–60.
Metadata
Title
Development and validation of a Chinese parental health literacy questionnaire for caregivers of children 0 to 3 years old
Authors
Yan Zhang
Mu Li
Hong Jiang
Huijing Shi
Biao Xu
Salla Atkins
Xu Qian
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-019-1670-9

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