Validation of the HLS-EU-Q6 and HLS-EU-Q16 questionnaire of Portuguese version - a methodological study

Abstract Background Health Literacy (HL) refers to the empowerment and competencies of individuals and the general population to navigate in the various areas of health care, to make decisions regarding their health in everyday life in an individual, family, or social context. Due to the dynamic process of health literacy, health professionals need to have a set of skills and real information that allow them to adapt to the changing landscape of people's literacy in order to empower them in the areas they need. To succeed, it is crucial to have the means to determine the health literacy level of the general population, in this case in the Portuguese context. Therefore, this study aims to validate the Portuguese version of HLS-EU-Q16 (HLS-EU-PT-Q16) and HLS-EU-Q6 (HLS-EU-PT-Q6) from the long form of HLS-EU-Q47 already validated for Portugal (HLS-EU-PT). Methods In order to analyse the results already obtained, a comparison was made with HLS-EU-PT index. Spearman correlation analysis was performed between the single items and scale scores. Cronbach’s alphas for all the indexes were calculated as a measure of internal consistency. For comparison associations between all the HL indexes - non-parametric test were calculated. The software used for the statistical analysis was SPSS (version 28.0). Results Cronbach’s alpha coefficient for HLS-EU-PT-Q16 internal consistency was 0.89 overall, and regarding HLS-EU-PT-Q6 the Cronbach’s alpha coefficient obtained was 0.777 overall. Indexes were not normally distributed, and Spearman correlation was computed. The results obtained in the correlation between G HL47 and G HL16 indexes (ρ = 0.949, p < 0.001) and the correlation between G HL6 and HLS-EU-PT-Q6 have a perfect correlation. Conclusions The HLS-EU-PT-Q16 and HLS-EU-PT-Q6 are concise and valid instruments to determine the health literacy level of the Portuguese population. However, the forms that show the smallest differences between the percentages of the levels of health literacy are the 47-item and the 16-item forms.