Abstract 13701: Development and Validation of a Heart Failure-Specific, Comprehensive Health Literacy Diagnostic Tool for Patients with Heart Failure

Abstract

Background: Health literacy (HL) is an important concept for patient education and disease management for heart failure (HF). However, research on HL has predominantly focused on functional HL (the ability to “read and write”), and WHO advocates evaluation of comprehensive HL, including the ability to access information (communicative HL) and critically evaluate this information (critical HL). We developed a tool for measuring three different level of HL, including functional, communicative, and critical HL among patients with HF.

Methods: The reliability and validity of these three HL scales were evaluated in a sample of 125 outpatients with HF (mean age, 63.5 ± 14.3 years; 65.1% male). In addition, sociodemographic and clinical characteristics as well as knowledge of HF were assessed for each patient through a self-reported questionnaire and review of electronic medical records.

Results: The scale items were constructed to directly reflect the definition of HL. Internal consistency for the functional, communicative, and critical HL scales was adequately high. (α = 0.742, α = 0.711, and α = 0.757, respectively). Three interpretable factors were identified in an exploratory factor analysis. Correlations between HL scales and other measures supported the construct validity of the scales. Test-retest reliability was also evaluated. The intraclass correlation coefficient of the scale was 0.79, and the weighted kappa for each individual item was 0.35-0.60; this result suggested that test-retest reliability was adequate. Low functional, communicative, and critical HL were characterized by older patients with lower socioeconomic status, who were living alone and were less likely to have high school education.

Conclusions: Our new HL scale was a reliable and valid tool for measuring functional, communicative, and critical HL in patients with HF. Exploring a patient’s HL level, including the ability to access, understand, and use health information as well as the ability to read and write may provide a better understanding of the patient’s potential barriers to self-management.