Development and Validation of the Chinese Health Literacy Scale for Chronic Care

Figures & data

Table 1. Demographics of study participants (N = 262)

Variable	n	%
Sex
Female	190	72.5
Age (years)
65–69	35	13.4
70–74	58	22.1
75–79	83	31.7
80–84	59	22.5
85–89	23	8.8
90 or older	4	1.5
Education level
No formal education	104	39.7
Grade 1–6	117	44.7
Grade 7–11	39	14.9
Grade 12 or higher	2	0.8
Chronic illness
Hypertension	210	80.2
Arthritis	122	46.6
Diabetes mellitus	90	34.4
Chronic obstructive pulmonary disease	15	5.7

Figure 1 Item selection of the four subscales of Chinese Health Literacy Scale for Chronic Care. The dotted lines represent the redundant items removed from the corresponding subscale.

Table 2. Results of the goodness-of-fit statistics of the Chinese Health Literacy Scale for Chronic Care

	No. of items	Overall goodness-of-fit		First eigenvalue ratio		Discrimination	Difficulty	Item goodness- of-fit		Percentage of correct
		Chi-square	p					Chi-square	p
Remembering							5.68
Before elimination	22	3314286	.08	16.27 ÷ 1.65 =	9.86
After elimination	12	1625.78	.71	9.18 ÷ 0.97 =	9.46	Item 1		−0.75	35.75	.437	82.1
						Item 2		−0.66	45.22	.351	80.5
						Item 3		−0.21	8.35	.682	72.5
						Item 4		−0.34	9.52	.649	74.8
						Item 5		−0.01	6.00	.782	67.9
						Item 6		0.22	9.01	.384	61.8
						Item 7		0.15	8.17	.450	63.7
						Item 8		−0.16	7.29	.682	71.4
						Item 9		0.36	11.84	.265	57.6
						Item 10		0.12	25.89	.139	64.5
						Item 11		−0.21	4.61	.868	72.5
						Item 12		0.48	11.02	.305	53.4
Understanding							1.47
Before elimination	8	138.34	.12	2.29 ÷ 1.00 =	2.29
After elimination	4	14.04	.18	1.82 ÷ 0.84 =	2.17	Item 1		−0.46	27.28	.776	61.8
						Item 2		0.34	40.54	.090	41.2
						Item 3		−0.16	22.23	.876	54.2
						Item 4		0.65	27.14	.667	33.6
Applying							1.23
Before elimination	7	273.84	.20	1.98 ÷ 1.11 =	1.78
After elimination	4	10.34	.34	1.57 ÷ 0.93 =	1.69	Item 1		−1.73	23.17	.574	84.4
						Item 2		−1.08	26.18	.733	73.7
						Item 3		−0.60	33.9	.743	63.7
						Item 4		0.05	50.84	.535	48.9
Analyzing							1.09
Before elimination	5	29.34	.22	1.66 ÷ 0.96 =	1.73
After elimination	4	14.48	.13	1.53 ÷ 0.94 =	1.63	Item 1		−1.72	29.06	.446	82.4
						Item 2		−0.87	39.31	.287	68.3
						Item 3		0.35	43.52	.842	42.4
						Item 4		−0.42	45.15	.228	59.2

Figure 2 Results of bifactor confirmatory factory analysis of the Chinese Health Literacy Scale for Chronic Care (CHLCC). RM = remembering; UN = understanding; AP = applying; AN = analyzing.

Table 3. Results of validity and reliability of the CHLCC

Discriminant validity	M (SD)	Coefficient
Demographic
Age		r=–0.31* * *
Chinese literacy	119.5 (71.8)	r = 0.80* * *
Sex		df = 156, t = 4.34* * *
Male	33.8 (8.9)
Female	28.1 (10.9)
Education		F = 51.80* * *
Grade 12 or higher	40.0 (2.8)
Grade 7–11	39.4 (6.9)
Grade 1–6	33.5 (8.3)
No formal education	21.9 (9.2)
Reliability		Cronbach's α
Overall scale		0.91
Subscale
Remembering		0.97
Understanding		0.60
Applying		0.49
Analyzing		0.45
Test–retest reliability		Intraclass correlation
Overall scale		0.77* *
Subscale
Remembering		0.90* * *
Understanding		0.66* *
Applying		0.38
Analyzing		0.51*