gms | German Medical Science

Background and status of (inter)national research: (Expectant) parents find themselves in a particularly challenging situation as they are confronted with a variety of new decisions that may affect the child's health and long-term development. Accordingly, recognizing and processing new and valid information is an important learning and developmental task for (expectant) parents.

Research question and objective: It is investigated whether a) the structure of Health literacy (HL) facet Access in (expectant) parents is consistent with the three domains Health care, Disease prevention, Health promotion validated by Finbråten et al. [1], b) the dimensional structure is valid independent of the domains of application (early childhood allergy prevention (ECAP), general health, COVID-19).

Method or hypothesis: To estimate the HL-facet Access in (expectant) parents the original and two adapted versions of HLS-EU-Q47were developed for the domains COVID-19 and Early childhood allergy prevention (ECAP). Structural analyses were performed using confirmatory methods for ordinal data (WLSMV algorithm).

Results: N = 362 (expectant) parents completed the three HLS-EU versions in an online assessment. The degree of agreement with the items varied significantly between the domains of application (η2 = .017-.463). Literacy scores were highest for COVID-19. A three-dimensional model distinguishing the application domains Health care, Disease prevention and Health promotion shows good to acceptable scores for the original and the COVID-19 adapted version (CFI = .964, .973; SRMR = .049, .054). For ECAP, the areas of Disease prevention and Health promotion merge, while Support represents a third factor (CFI = .964, SRMR = .048).

Discussion: The results suggest that access not only reflects parental HL but also individual requirements for the quality of search results. The demonstrated domain dependence of item (esp. level of parental agreement; item difficulty) and construct properties (item-construct associations, dimensionality) represent an important starting point for further analyses. In particular, the analysis of differential properties of parental HL (psychological aspect) in contrast to the availability of health information (public health aspect) is an important research desideratum both for the development of theories on parental HL and the possibility of diagnostic assessment.

Practical implications: The results raise the fundamental question of whether subjective methods rather than objective tests, which are conceptually more valid for measuring competencies such as health literacy, can provide sufficiently valid information in epidemiologic studies.

Appeal for practice (science and/or care) in one sentence: The findings contribute to a more valid domain-specific understanding of the HLS-EU facet Access and confirm its central role (second-order construct) for parental HL.

Funding: Sonstige Förderung; FOR 2959