ABSTRACT

Health literacy has been identified as a significant predictor of healthcare utilization among refugee and immigrant communities. Considering its potential impact on their health outcomes, accurately measuring levels of health literacy among limited English proficiency (LEP) populations is an important area of investigation. This study examined the psychometric properties of a modified version of the All Aspects of Health Literacy Scale (AAHLS), based on Nutbeam’s model of health literacy, using an exploratory factor (EFA) and confirmatory factor (CFA) analysis among a sample of Karen refugees, an ethnic minority group from Burma. Results of the EFA confirmed a 3-factor model in our sample. CFA results indicated good model fits, demonstrating a promising use of the AAHLS in assessing health literacy among Karen refugees. The findings of this study support the validity of using this measure among this population and suggest some necessary adjustments to incorporate factors unique to the refugee experience that may affect the interpretation and application of items in the AAHLS. Further replication using other LEP samples is necessary to confirm the psychometric properties of the AAHLS and its ability to assess health literacy using Nutbeam’s theoretical model of health literacy.

摘要

健康素养已被确定为难民和移民社区医疗保健利用的重要预测指标。考虑到其对健康结果的潜在影响，准确测量英语能力有限 (LEP) 人群的健康素养水平是一个重要的调查领域。本研究基于 Nutbeam 的健康素养模型，使用探索性因素 (EFA) 和验证性因素 (CFA) 对克伦难民样本进行分析，检验了修改版的健康素养各方面量表 (AAHLS) 的心理测量特性，来自缅甸的少数民族。EFA 的结果证实了我们样本中的三因素模型。CFA 结果表明模型拟合良好，表明 AAHLS 在评估克伦难民的健康素养方面很有前景。本研究的结果支持在这一人群中使用该措施的有效性，并建议进行一些必要的调整，以纳入可能影响 AAHLS 中项目的解释和应用的难民经历的独特因素。有必要使用其他 LEP 样本进行进一步复制，以确认 AAHLS 的心理测量特性及其使用 Nutbeam 的健康素养理论模型评估健康素养的能力。