Development of a comprehensive health literacy scale for Japanese workers: a pilot study in Niigata Prefecture

Abstract

  This study was designed to develop a comprehensive health literacy scale (CHLS-J) for improving the health behavior of Japanese workers. A 45-item questionnaire was developed in a form that considered motivation, knowledge, and ability as these aspects are related to health literacy (HL) definitions (Nutbeam, 1998). It also measured access, understand, appraise, and apply as these are related to HL processes (Sørensen et al., 2012). The subjects in this survey study were 148 anonymous workers in Niigata Prefecture. An exploratory factor analysis (maximum likelihood method, promax rotation) was used to consider the factor structure of the HL scale, and the internal consistency of the scale was evaluated using Cronbach's coefficient alpha. The criterion-related validity was evaluated using Spearman's rank correlation (r_s) coefficient between the scores of the CHLS-J, 14-item HL scale (HLS-14) (Suka et al., 2013), and communicative and critical HL scale (CCHL) (Ishikawa et al., 2008b). Based on the result of factor analysis, 31 HL items were extracted, and the factor structure was based on three factors (“the knowledge and competencies for collecting health information,” “decision-making and communication,” and “the motivation for utilizing the health information”). The internal consistency of each HL score, as indicated by Cronbach's alpha, was satisfactory, with each factor having a Cronbach's coefficient alpha of > 0.88. The correlation analysis indicated a significant positive correlation with the scores of other HL scales (HLS-14: r_s = 0.57, CCHL: r_s = 0.64). The CHLS-J demonstrated adequate reliability and validity as a feasible HL scale for Japanese workers.