title: The comprehensibility of health education programs: questionnaire development and results in patients with chronic musculoskeletal diseases.
abstract: OBJECTIVE
  The objective was to develop a comprehensive questionnaire for measuring the patient-perceived comprehensibility of health education programs (COHEP questionnaire). According to a conceptual model outlined in the article, comprehensibility is considered a context factor of patient health literacy.
  
  
  METHODS
  A questionnaire study was carried out on N=577 patients with chronic musculoskeletal diseases. During inpatient rehabilitation, patients participated in standardized, interactive group education programs conducted by clinic personnel. Factorial structure, unidimensionality, reliability, fit to the Rasch model, and construct validity were tested.
  
  
  RESULTS
  The COHEP consists of 30 items and 4 scales (comprehension-fostering behavior of program trainers, transferability to everyday life, comprehensibility of medical information, amount of information). All scales are reliable, unidimensional, and meet the requirements of the Rasch model. In addition, there are initial indications of validity. The descriptive results show that the overall rating of the comprehensibility of patient education programs in the German rehabilitation system is good, but that there are clear differences between centers.
  
  
  CONCLUSIONS
  The COHEP can be used to evaluate health education programs, since it measures an important proximal outcome.
  
  
  CONCLUSIONS
  An analysis of patient-perceived comprehensibility can help providers adapt education sessions better to the health literacy of patients.
authors.affiliation: University Freiburg - Medical Center, Department of Quality Management and Social Medicine, Freiburg, Germany. erik.farin@uniklinik-freiburg.de
authors.forename: Erik
authors.initials: E
authors.lastname: Farin
authors.forename: Michaela
authors.initials: M
authors.lastname: Nagl
authors.forename: Antje
authors.initials: A
authors.lastname: Ullrich
mesh_terms: D000328:Adult; D002908:Chronic Disease; D032882:Comprehension; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011320:Primary Health Care; D015397:Program Evaluation; D011594:Psychometrics / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires