BACKGROUND Health literacy (HL) is defined as the knowledge and competences of people to meet the complex demands of health in modern society. It is an important factor in ensuring positive health outcomes, yet Iceland is one of many countries with limited knowledge of HL and no valid HL measurement. The aim of this study was to translate the European Health Literacy Survey Questionnaire- short version (HLS-EU-Q16) into Icelandic, adapt the version, explore its psychometric properties and establish preliminary norms. METHODS The HLS-EU-Q16 translation model included three steps: 1) translation-back-translation of HLS-EU-Q16 including specialists' review (n = 6); 2) cognitive interviewing of lay people (n = 17); and 3) psychometric analysis with survey participants. The HLS-EU-Q16 includes 16 items, with scores ranges from zero (low/no HL) to 16 (high HL). Statistics included were descriptive, internal consistency measured by Cronbach's α, exploratory factor analysis, and multivariate linear regression. RESULTS After the translation and cognitive interviewing, 11 of the HLS-EU-Q16 items were reworded to adapt the instrument to Icelandic culture while maintaining their conceptual objectives. Survey participants were 251. Internal consistency of the translated and adapted instrument was α = .88. Four factors with eigenvalues > 1.0 explained 62.6% of variance. Principal component analysis with Oblimin rotation presented four latent constructs, "Processing and Using Information from the Doctor" (4 items, α = .77), "Processing and Using Information from the Family and Media" (4 items, α = .85), "Processing Information in Connection to Healthy Lifestyle" (5 items, α = .76), and "Finding Information about Health Problems/Illnesses" (3 items, α = .73). Lower self-rated health was an independent predictor of lower HL (β = -.484, p = .008). Preliminary norms for HL ranged from five to 16 (M 13.7, SD ± 2.6) with 72.5% with sufficient HL (score 13-16), 22% with problematic HL (score 9-12) and 5.5% with inadequate HL (score 0-8). CONCLUSIONS The Icelandic version of HLS-EU-Q16 is psychometrically sound, with reasonably clear factor structure, and comparable to the original model. This opens possibilities to study HL in Iceland and compare the results internationally. The translation model introduced might be helpful for other countries where information on HL is missing based on lack of validated tools.

中文翻译：

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《欧洲健康素养调查问卷》（HLS-EU-Q16）的翻译和跨文化改编：冰岛语版本。

背景技术健康素养（HL）被定义为人们满足现代社会对健康的复杂需求的知识和能力。这是确保取得积极健康成果的重要因素，但是冰岛是许多对HL知识了解有限且没有有效HL量度的国家之一。这项研究的目的是将欧洲健康素养调查问卷简短版（HLS-EU-Q16）译成冰岛文，改编该版本，探索其心理计量学特征并建立初步规范。方法HLS-EU-Q16的翻译模型包括三个步骤：1）HLS-EU-Q16的翻译-反向翻译，包括专家审查（n = 6）；2）外行人的认知访谈（n = 17）；3）与调查参与者进行心理分析。HLS-EU-Q16包括16个项目，分数范围从零（低HL /无HL）到16（高HL）。包括的统计数据包括描述性数据，通过Cronbach'sα测量的内部一致性，探索性因素分析和多元线性回归。结果经过翻译和认知访谈后，对HLS-EU-Q16的11个条目进行了改写，以使该乐器适应冰岛文化，同时保持其概念目标。参与调查的参与者为251。翻译和调整后的工具的内部一致性为α= .88。特征值> 1.0的四个因子解释了62.6％的方差。通过Oblimin旋转进行的主成分分析提出了四个潜在构造，“处理和使用来自医生的信息”（4个项，α= .77），“处理和使用来自家庭和媒体的信息”（4个项，α= .85） ，“