title: Self-administered health literacy instruments for people with diabetes: systematic review of measurement properties.
abstract: OBJECTIVE
  The aims of this study were to identify all available self-administered instruments measuring health literacy in people with diabetes and to determine the current instrument that is the most appropriate for applying to this population in both practice and research.
  
  
  METHODS
  A systematic review of measurement properties.
  
  
  METHODS
  MEDLINE, EMBASE and CINAHL electronic databases from their inception up to 28 March 2016.
  
  
  METHODS
  The methodological quality of each included study was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The reported results for measurement properties in the studies were assessed according to Terwee's quality criteria.
  
  
  RESULTS
  Thirteen self-administered instruments measuring health literacy in people with diabetes were identified, of which six (44%) were diabetes-specific instruments. The instruments that covered the broadest contents of health literacy were the Health Literacy Scale and Health Literacy Questionnaire. The (test-retest) reliability, measurement error and responsiveness were not evaluated for any instrument, while internal consistency and hypothesis testing validity were the most frequently assessed measurement properties.
  
  
  CONCLUSIONS
  With the current evidence, the Health Literacy Scale may be the most appropriate instrument for patients with diabetes in practice and research. However, the structural validity of this scale needs to be further established, particularly in other language versions. It is also recommended to use the Diabetes Numeracy Test-15 along with the Health Literacy Scale to complement the lack of numeracy measures in the Health Literacy Scale.
authors.affiliation: Graduate School of Public Health, Ajou University, Suwon, Korea.
authors.forename: Eun-Hyun
authors.identifier: http://orcid.org/0000-0001-7188-3857
authors.initials: EH
authors.lastname: Lee
authors.affiliation: College of Nursing and Institute of Nursing Science, Ajou University, Suwon, Korea.
authors.forename: Chun-Ja
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: College of Nursing, Chungnam National University, Daejeon, Korea.
authors.forename: Jiyeon
authors.identifier: http://orcid.org/0000-0001-6413-329X
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Nursing, Graduate School, Inha University, Incheon, Korea.
authors.forename: Seung Hei
authors.identifier: http://orcid.org/0000-0002-8215-7612
authors.initials: SH
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000628:therapy*; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000295:instrumentation* / Q000379:methods*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: diabetes; health literacy; instrument; nursing; psychometric properties; questionnaire; reliability; scale; systematic review; validity