Development and validation of the high blood pressure-focused health literacy scale

Objective: While the role of health literacy in chronic disease management is well documented, few intervention studies have been reported. A major barrier to designing and implementing such interventions is the lack of valid health literacy tools. This study developed and tested a novel health literacy scale for individuals with high blood pressure (HBP). Methods: A two-step design process was used: In the construction phase, focus group studies and a literature review were conducted to generate a pool of items. The testing phase involved a psychometric evaluation and pilot-testing of the scale on hypertensive Korean Americans (n= 386). The end product was a HBP-health literacy scale (HBP-HLS) with two essential domains, print literacy and functional health literacy. Results: Psychometric testing indicated that the scale was reliable (Kuder-Richardson-20 coefficient = 0.98), valid (content validity index ≥0.8), and significantly correlated with theoretically selected variables (education, r= 0.67, p< 0.01; HBP knowledge, r= 0.33, p< 0.01). Conclusion: The HBP-HLS demonstrated its utility for evaluating HBP management interventions in the community setting. Practice implications: Utilizing the HBP-HLS should be considered as a potential tool for improving health literacy and evaluating intervention studies in the context of HBP management.