title: Development of health literacy scale among Brazilian mothers in Japan.
abstract: Japanese-Brazilians were the third largest immigrant group in Japan in 2011. Their health issues have caused concern, as their limited language made them vulnerable by hindering access to health services. Upon considering child health, mothers' health literacy (HL) is very important. This study aimed to develop a health literacy scale among Brazilian mothers (HLSBM) in Japan. Questionnaires in Portuguese were distributed to 1474 mothers from December 2011 to March 2012. Among 698 collected, 558 questionnaires were analyzed. We prepared 29 candidate items for HLSBM based on Nutbeam's concept of functional, interactive and critical literacy. The dimensional structure was determined statistically using confirmatory factor analysis. Validity was also analyzed by Pearson's correlation with Ishikawa's scale and Kendall's coefficient of concordance among researchers. Cronbach's α coefficients were calculated to examine internal consistency. The confirmatory factor analysis revealed a two-factor model (five items for basic literacy and five items for critical literacy) with sufficient goodness of fit (GFI 969, AGFI 945, NFI 959, CFI 972, RMSEA 060). The internal consistency values of the total score, basic and critical literacy sub-scales were 0.819, 0.889 and 0.667, respectively. Kendall's coefficient of concordance showed good agreement of researchers (p < 0.001). Pearson's correlation coefficients with Ishikawa's scale were 0.554 for total score, 0.446 for basic literacy and 0.472 for critical literacy. The HLSBM consisting of two factors was confirmed to be valid and reliable. The HLSBM must be useful for understanding this vulnerable group's health literacy and its associated factors.
authors.affiliation: Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyotanabe, Kyoto, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Hashimoto
authors.affiliation: School of Nursing and Health, Aichi Prefectural University, Nagoya, Aichi, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Yanagisawa
mesh_terms: D000328:Adult; D001938:Brazil / Q000208:ethnology; D005260:Female; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D007564:Japan; D007802:Language; D009035:Mothers / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Japanese-Brazilian; health literacy; measurement