title: Validation of the Test of Functional Health Literacy in Adults in a Danish population.
abstract: OBJECTIVE
  To describe how the original American full-length version of the Test of Functional Health Literacy in Adults (TOFHLA) was translated and adapted for use in the Danish setting and culture. A reliable Danish version of the TOFHLA was created and pretested using patients diagnosed with chronic obstructive pulmonary disease (COPD) as case group.
  
  
  METHODS
  Forty-two patients with COPD completed the Danish TOFHLA and participated in a face-to-face interview concerning their basic demographics. Statistical analyses were conducted to explore the demographic data provided by the participants and to determine the internal consistency and reliability of the Danish TOFHLA.
  
  
  RESULTS
  The mean age of sample was 68.7 years (range 34-86). The face validity, internal consistency and item to scale correlations of the Danish TOFHLA were determined and found to fulfil well-established criteria; on this basis, we found the reliability and consistency of the Danish TOFHLA to be satisfying.
  
  
  CONCLUSIONS
  The Danish TOFHLA is now ready for application in future research projects, which test levels of functional health literacy in an elderly Danish population at risk of chronic diseases. The evolvement in the measurement of health literacy is still ongoing, as there is a need to refine existing methods. Until recently, there has been a total lack of instruments for assessing health literacy in Scandinavia; it is hoped that this development of the Danish TOFHLA will promote further research within the field of health literacy in Scandinavia and other European countries.
authors.affiliation: Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Lisa Korsbakke
authors.initials: LK
authors.lastname: Emtekaer Haesum
authors.affiliation: Danish Center for Healthcare Improvements, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University, Aalborg, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Ehlers
authors.affiliation: Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.|Department of Computer Science, University of Tromsø, Tromsø, Norway.
authors.forename: Ole K
authors.initials: OK
authors.lastname: Hejlesen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003469:Culture; D003718:Denmark; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008780:Methyltransferases; D008875:Middle Aged; D015203:Reproducibility of Results; D029701:Saccharomyces cerevisiae Proteins; D013997:Time Factors; D014175:Translating
chemical_list: D029701:Saccharomyces cerevisiae Proteins; D008780:Methyltransferases; C535246:TAE1 protein, S cerevisiae
keywords: Denmark; Test of Functional Health Literacy in Adults; chronic disease; chronic obstructive pulmonary disease; communication; health literacy; reliability