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This study developed a self-report measure for easy assessing of the health literacy of Asian immigrant women in South Korea.
Methods
After a literature review, focus group interviews, and content validity evaluation, 14 preliminary items were generated. These were translated into Chinese, Vietnamese, and English. Data were collected from 229 Asian immigrant women. Validity and reliability tests were conducted.
Results
Factor analysis yielded final 10 items in three factors: primary functional and interactive health literacy, secondary functional and interactive health literacy, and critical health literacy, which explained 61.90% of the total variance of health literacy. In known-group comparisons, health literacy was significantly lower in recent immigrants, those with a low education level, and those with low Korean language proficiency. For convergent validity, health literacy was positively associated with health specific self-efficacy and maternal health knowledge. For criterion-related validity, health literacy was positively associated with the REALM-SF. The overall reliability coefficient (Cronbach's ⍺) of the instrument was .773.
Conclusion
The Health Literacy Assessment Scale for Asian Immigrant Women (HLAS) represents a multidimensional construct which encompasses functional, interactive, and critical health literacy. This self-report HLAS can be a useful and convenient method for appraising the health literacy of Asian immigrant women.
7. I am able to describe my symptoms directly to the doctor.
.77
.62
2. By looking at the packaging, I can understand how to take my medication.
.71
.46
9. If I am curious about my own or my family's health, I am able to ask the doctor.
.61
.47
4. When I went to the hospital, I was able to find where I wanted to go by following the signs.
.52
.35
6. I need another person's help to book my next appointment.
−.77
.59
3. I need another person's help to fill out various hospital forms (surgery consent forms, examination consent forms, vaccination pretest chart, etc.)
−.74
.51
8. It is difficult to understand the doctor's explanations.
−.65
.50
1. I find medical terminologies that I don't understand in health related information received from the hospital.
−.53
.31
13. I consistently follow healthy lifestyle habits (exercise, diet, not smoking, not consuming alcohol, etc.).
.64
.40
11. When I buy foodstuffs, I check the ingredients on the packaging.
.51
.36
Eigen value
3.38
1.73
1.08
Proportion of variances (%)
33.80
17.30
10.80
Total variances (%)
33.80
51.10
61.90
KMO=.77; Bartlett test of sphericity=558.90, p<.001
Cronbach's ⍺
.76
.77
.55
Total Cronbach's ⍺=.77
HLAS=Health Literacy Assessment Scale for Asian Immigrant Women;
† Secondary functional and interactive health literacy;
‡ Primary functional and interactive health literacy;
§ critical health literacy.
Table 3.
Differences in HLAS by Time Since Immigration, Education and Korean Proficiency
Variables
Characteristics
Categories
Total score of HLAS
M±SD
F
p (post hoc)
Time since immigration (year)
<1a
18.40±6.57
14.27
<.001
1~<3b
19.32±5.57
(a, b<c, d)
3~<5c
23.12±5.86
≥5d
24.91±6.00
Education
Elementary schoola
17.21±7.54
3.74
.012
Middle schoolb
21.74±6.38
(a<d)
High schoolc
21.83±5.72
≥Colleged
23.13±7.00
Korean proficiency
Speaking
Poora
17.92±6.12
33.91
<.001
Moderateb
22.32±5.18
(a<b<c)
Goodc
28.41±6.68
Listening
Poora
17.51±6.15
26.59
<.001
Moderateb
22.30±5.29
(a<b<c)
Goodc
26.60±7.11
Reading
Poora
16.62±5.42
35.12
<.001
Moderateb
22.54±5.32
(a<b<c)
Goodc
26.34±7.00
Writing
Poora
18.03±5.84
24.74
<.001
Moderateb
22.83±5.57
(a<b<c)
Goodc
26.52±7.11
HLAS=Health literacy assessment scale for asian immigrant women.
Table 4.
Convergent and Criterion-related Validity Evaluation of HLAS
Variables
Total score of HLAS
ɼ
p
Health specific self-efficacy
.21
.003
Maternal health knowledge
.40
<.001
REALM-SF
.56
<.001
HLAS=Health literacy assessment scale for asian immigrant women; REALM-SF=Rapid estimate of adult literacy in medicine-short form.
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Figure & Data
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