Journal Article

Developing and evaluating a relevant and feasible instrument for measuring health literacy of Canadian high school students

Amery D. Wu, Deborah L. Begoray, Marjorie MacDonald, Joan Wharf Higgins, Jim Frankish, Brenda Kwan, Winny Fung and Irving Rootman

in Health Promotion International

Volume 25, issue 4, pages 444-452
Published in print December 2010 | ISSN: 0957-4824
Published online May 2010 | e-ISSN: 1460-2245 | DOI:
Developing and evaluating a relevant and feasible instrument for measuring health literacy of Canadian high school students

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Health literacy has come to play a critical role in health education and promotion, yet it is poorly understood in adolescents and few measurement tools exist. Standardized instruments to measure health literacy in adults assume it to be a derivative of general literacy. This paper reports on the development and the early-stage validation of a health literacy tool for high school students that measured skills to understand and evaluate health information. A systematic process was used to develop, score and validate items. Questionnaire data were collected from 275, primarily 10th grade students in three secondary schools in Vancouver, Canada that reflected variation in demographic profile. Forty-eight percent were male, and 69.1% spoke a language other than English. Bivariate correlations between background variables and the domain and overall health literacy scores were calculated. A regression model was developed using 15 explanatory variables. The R2 value was 0.567. Key findings were that lower scores were achieved by males, students speaking a second language other than English, those who immigrated to Canada at a later age and those who skipped school more often. Unlike in general literacy where the family factors of mother's education and family affluence both played significant roles, these two factors failed to predict the health literacy of our school-aged sample. The most significant contributions of this work include the creation of an instrument for measuring adolescent health literacy and further emphasizing the distinction between health literacy and general literacy.

Keywords: health literacy; adolescents; measurement; instrument

Journal Article.  4500 words.  Illustrated.

Subjects: Public Health and Epidemiology

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