Iranian Health Literacy Questionnaire (IHLQ): An Instrument for Measuring Health Literacy in Iran.
BACKGROUND
Promoting Health Literacy (HL) is considered as an important goal in strategic plans of many countries. In spite of the necessity for access to valid, reliable and native HL instruments, the number of such instruments in the Persian language is scarce. Moreover, there is no good estimation of HL status in Iran.


OBJECTIVE
The aim of this study was to provide a valid, reliable and native instrument to measure and monitor community HL in Iran and also, to provide an estimation of HL status in two Iranian provinces.


METHODS
By applying the multistage cluster sampling, 1080 respondents (540 from each gender) were recruited from Kerman and Mazandaran provinces of Iran, from February to June 2014 to participate in this cross-sectional study. The development of the Iranian Health Literacy Questionnaire (IHLQ) was initiated with a comprehensive review of the literature. Then, face, content and construct validity as well as reliability were determined.


RESULTS
Internal consistency and test-retest reliability (ICC) of the factors was in the range of 0.71 to 0.96 and 0.73 to 0.86, respectively. In order to construct validity, Exploratory Factor Analysis (EFA) Kaiser-Meyer-Olkin (KMO) = 0.95 and Bartlett's test result of 3.017 with P < 0.001) with varimax rotation was used. Optimal reduced solution, including 36 items and seven factors, was found in EFA. Five of the factors identified were reading/comprehension skills, individual empowerment, communication/decision-making skills, social empowerment and health knowledge.


CONCLUSIONS
It was concluded that IHLQ might be a practical and useful tool for investigating HL for Persian language speakers around the world. Since HL is dynamic and its instruments should be regularly revised, further studies are recommended to assess HL with application of IHLQ to detect its potential imperfections.
Research Center for Modeling in Health, Institute for Future Studies, Kerman University of Medical Sciences, Kerman, IR Iran.
Ali Akbar
AA
Haghdoost
School of Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Fatemeh
F
Rakhshani
School of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.
Mohsen
M
Aarabi
Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, IR Iran.
Ali
A
Montazeri
Health Education and Promotion Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, IR Iran.
Mahmoud
M
Tavousi
Health Education Office, Health Departments, Ministry of Health and Medical Education, Tehran, IR Iran.
Atoosa
A
Solimanian
Health Education Office, Health Departments, Ministry of Health and Medical Education, Tehran, IR Iran.
Fatemeh
F
Sarbandi
Health Education Office, Health Affairs, Mazandaran University of Medical Sciences, Sari, IR Iran.
Hosein
H
Namdar
Department of Health Education and Promotion, School of Health and Health Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
Abedin
A
Iranpour
Health Literacy; Instrumentation; Iran