Cross-Cultural Validation of the High Blood Pressure Health Literacy Scale in a Chinese Community.
Considering the importance of health literacy (HL) for the maximum yield from the hypertension control programs, development of a reliable and valid instrument of hypertension-related HL is critical. This study aimed to translate and validate the High Blood Pressure-Health Literacy Scale (HBP-HLS) into Chinese (C-HBP-HLS) and evaluate its psychometric properties in Chinese context.



Between June 2013 and January 2014, a cross-sectional study was conducted among recruited hypertensive patients belonging to the Han and Kazakh-Chinese communities in Urumqi, Xinjiang, China.



A pilot sample (n = 242) was selected for the exploratory factor analysis of the translated and modified instrument. Another sample (n = 308) was recruited for the confirmatory factor analysis. C-HBP-HLS consisted of five dimensions (Print Health Literacy, Medication Label, Understanding Ability, Newest Vital Sign Test, and Avoiding Food Allergy) containing 15 items, accounting for 77.7% of the total variance. The 5-factor model demonstrated a good overall fit. The scale-level content validity index was 0.85. Cronbach's alpha of the overall scale was 0.78 and test-retest reliability was 0.96. Education level had a strong positive correlation with the scores for items Q1, Q2, and Q3(r = 0.481, 0.492, 0.475, respectively). Health Literacy scores among Kazakh patients were significantly lower than Han (7.13±7.90 vs. 30.10±13.42, Z = -14.573, P<0.001).



C-HBP-HLS demonstrated suitable factor structure and robust psychometric properties for measuring health literacy level among hypertensive patients in China.
Xiang Ya Nursing School, Central South University, Changsha, Hunan, China.|School of Nursing, XinJiang Medical University, Urumqi, XinJiang, China.
Qinghua
Q
Zhang
School of Nursing, FuJian Medical University, Fu Zhou, Fu Jian, China.
Feifei
F
Huang
School of Public Health, XinJiang Medical University, Urumqi, XinJiang, China.
Zaoling
Z
Liu
School of Public Health, University of Hong Kong, Hong Kong, China.
Na
N
Zhang
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, United States of America.
Tanmay
T
Mahapatra
University of North Carolina Project-China, Guangzhou, China.
Weiming
W
Tang
Xiang Ya Nursing School, Central South University, Changsha, Hunan, China.
Yang
Y
Lei
School of Nursing, XinJiang Medical University, Urumqi, XinJiang, China.
Yali
Y
Dai
University of North Carolina Project-China, Guangzhou, China.
Songyuan
S
Tang
Xiang Ya Nursing School, Central South University, Changsha, Hunan, China.
Jingping
J
Zhang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology; D005260:Female; D057220:Health Literacy / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000517:prevention & control* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D055815:Young Adult