title: Measuring health literacy regarding infectious respiratory diseases: a new skills-based instrument.
abstract: BACKGROUND
  There is no special instrument to measure skills-based health literacy where it concerns infectious respiratory diseases. This study aimed to explore and evaluate a new skills-based instrument on health literacy regarding respiratory infectious diseases.
  
  
  METHODS
  This instrument was designed to measure not only an individual's reading and numeracy ability, but also their oral communication ability and their ability to use the internet to seek information. Sixteen stimuli materials were selected to enable measurement of the skills, which were sourced from the WHO, China CDC, and Chinese Center of Health Education. The information involved the distribution of epidemics, immunization programs, early symptoms, means of disease prevention, individual's preventative behavior, use of medications and thermometers, treatment plans and the location of hospitals. Multi-stage stratified cluster sampling was employed to collect participants. Psychometric properties were used to evaluate the reliability and validity of the instrument.
  
  
  RESULTS
  The overall degree of difficulty and discrimination of the instrument were 0.693 and 0.482 respectively. The instrument demonstrated good internal consistency reliability with a Cronbach's alpha of 0.864. As for validity, six factors were extracted from 30 items, which together explained 47.3% of the instrument's variance. And based on confirmatory factor analysis, the items were grouped into five subscales representing prose, document, quantitative, oral and internet based information seeking skills (χ(2) = 9.200, P>0.05, GFI = 0.998, TLI = 0.988, AGFI = 0.992, RMSEA = 0.028).
  
  
  CONCLUSIONS
  The new instrument has good reliability and validity, and it could be used to assess the health literacy regarding respiratory infectious disease status of different groups.
authors.affiliation: Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China.
authors.forename: Xinying
authors.initials: X
authors.lastname: Sun
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.forename: Yuhui
authors.initials: Y
authors.lastname: Shi
authors.forename: Qingqi
authors.initials: Q
authors.lastname: Zeng
authors.forename: Nanfang
authors.initials: N
authors.lastname: Wei
authors.forename: Ruiqian
authors.initials: R
authors.lastname: Xie
authors.forename: Chun
authors.initials: C
authors.lastname: Chang
authors.forename: Weijing
authors.initials: W
authors.lastname: Du
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods*; D005163:Factor Analysis, Statistical; D005260:Female; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D012140:Respiratory Tract Diseases / Q000175:diagnosis*; D063508:Social Discrimination; D011795:Surveys and Questionnaires; D055815:Young Adult