A psychometric evaluation of the Health Literacy Questionnaire for Chinese immigrants: Linguistic and cultural considerations.

Objective: Health literacy is an important predictor of health outcomes. The Health Literacy Questionnaire has been widely adopted to measure health literacy and has been translated into multiple languages including Chinese. This study aims to evaluate the psychometric properties of the simplified Chinese Health Literacy Questionnaire. Methods: Data were obtained from a sample of 362 Chinese immigrants from Chinese community organizations in New South Wales, Australia. Statistical analyses include descriptive and exploratory factor analyses. Results: A seven‐factor solution was derived from 39 of the original 44 items, all with acceptable to excellent internal consistency but differing from the original construction. The health literacy subscale scores were negatively associated with age and with age at immigration, but positively associated with duration of stay (years) in Australia, better English proficiency and current employment. Differing interpretations of the questions based on Chinese culture could possibly explain the variations between the two versions. Conclusion: The simplified Chinese Health Literacy Questionnaire measures some central concepts of health literacy well. However, the questionnaire may require further development, especially in linguistic and cultural aspects. SUMMARY STATEMENT: What is already known about this topic? The Health Literacy Questionnaire has been translated and validated in multiple languages with good reliability and validity. What this paper adds? The study addresses issues that may be related to cultural adaptation and language interpretation of the simplified Chinese version of the Health Literacy Questionnaire. The implications of this paper: It is important for researchers and clinicians to evaluate the cultural sensitivity of translated questionnaires within the specific context before application. [ABSTRACT FROM AUTHOR]