gms | German Medical Science

Background: Individual health literacy (HL) “entails people's knowledge, motivation and competences to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention and health promotion” (Sorensen et al. [1], p. 3). Many instruments exist to assess various aspects of individual HL in different settings. So far, there is a lack of instruments measuring COVID-19 related health literacy (HL-COV) in healthcare professionals.

Research question: The aim of our study was to develop a survey instrument assessing HL-COV in healthcare professionals.

Methods: A set of 12 items that scored on a scale from “very easy”, “fairly easy”, “fairly difficult” to “very difficult” was developed. The items were adapted from the unidimensional HLS-EU-Q16 instrument, which measures general HL based on the respondents’ ease with accessing, understanding, processing, and applying information in the domains healthcare, disease prevention, and health promotion. Data from healthcare professionals in Germany were collected with an online survey from April to July 2020. Descriptive measures of the items and both exploratory and confirmatory factor analysis (EFA, CFA) were applied.

Preliminary results: A sample of n=986 health professionals filled in the HL-COV questionnaire (missing data 2.1% per item, deleted listwise for analyses). The sample consisted mainly of physicians (23.0%) and nurses (28.3%), the majority of the participants was female (72.2%) and about one third was 51–60 years old. Sampling adequacy was confirmed with the Kaiser-Meyer-Olkin measure (KMO=0.898; good) and MSA values per item that exceeded the minimum of 0.5 (MSA≥0.810). A significant Bartlett’s test of sphericity χ² (66)=4817.210, p<0.001 indicated that the data were suitable for EFA. Factors were extracted with main component analysis. First results suggest that the 12 items load on one component, explaining 44.7% of the variance. The CFA replicated the one factor structure of the HLS-EU-Q16. After allowing three error terms to correlate, the model fit measures were: χ²=308.540, df=51, χ²/df=6.050, p=0.000, RMSEA=0.072, CFI=0.946, and TLI=0.930. Cronbach’s alpha was 0.882.

Discussion: The CFA shows acceptable model fit. The HL-COV-HP is a short and feasible instrument to measure HL-COV in health professionals. Future psychometric evaluations will have to examine test-retest reliability, sensitivity to change, and responsiveness of the instrument.

Practical implications: The instrument can be used to monitor HL-COV in health professionals in different phases of the COVID-19 pandemic or in different settings or health care systems. Moreover, associations between HL-COV on the one side and individual as well as professional health behavior and outcomes on the other side can be examined.