Health Literacy Assessment Tool related to Antenatal Care (HLAT-ANC) for Pregnant Women: A Methodological Research from Turkey

Abstract

Objective: It is important to provide adequate antenatal care (ANC) for the lowest maternal- fetal complications in pregnancy. The increase in the level of health literacy increases the quality of the ANC, and compliance with the follow-up. To develop a tool to evaluate health literacy (HL) levels of pregnant women in antenatal care (ANC). Methods: This study is methodological research conducted between 15.02.2016-01.07.2018. "Health Literacy Assessment Tool related to Antenatal Care (HLAT-ANC)" was developed. Its validity-reliability was tested by item analysis, exploratory factor analysis (EFA), concurrent criterion validity, intergroup dissociation, and confirmatory factor analysis (CFA), and determination of the Kuder-Richardson-20 (KR-20) coefficient. Results: The discrimination coefficients of the items in HLAT-ANC varied between 0.20- 0.57 and factor loads between 0.34-0.85. It was determined that HLAT-ANC has KR-20≥0.85 in each subdomain. The scores of fit criteria obtained in the confirmatory factor analysis were within acceptable limits. Conclusions: HLAT-ANC was found to be a valid and reliable scale.

Keywords

• Health literacy
• Antenatal care
• Pregnancy
• Methodological research

Gebelerin Doğum Öncesi Bakım İle İlgili Sağlık Okuryazarlık Düzeylerini Değerlendirme Aracının Geliştirmesi: Metadolojik Bir Çalışma, Türkiye

Abstract

Amaç: Gebelikte maternal-fetal komplikasyonları en aza indirmek için yeterli doğum öncesi bakım (DÖB) alınması önemlidir. Sağlık okuryazarlık (SOY) düzeyinin yükseltilmesi, DÖB’nin kalitesini ve takibe uyumu arttırmaktadır. Bu çalışmada gebelerin DÖB ile ilgili SOY düzeylerini değerlendirme aracının geliştirilmesi amaçlandı. Gereç ve Yöntem: Bu çalışma 15.02.2016-01.07.2018 tarihleri arasında gerçekleştirilen metadolojik bir araştırmadır. Doğum Öncesi Bakıma İlişkin Sağlık Okuryazarlığı Değerlendirme Aracı (DÖB-SOY)" geliştirildi. Geçerlik ve güvenirlik için, madde analizi, açımlayıcı faktör analizi (AFA), eşzamanlı ölçüt geçerliliği, gruplar arası ayrışma, doğrulayıcı faktör analizi (DFA) ve Kuder-Richardson-20 (KR-20) katsayısı hesaplandı. Bulgular: DÖB-SOY’un maddelerinin ayırt edicilik katsayıları 0.20-0.57 arasında, faktör yükleri 0.34-0.85 arasında değişmektedir. KR-20, herbir alt alanda ≥0.85 olarak hesaplandı. Doğrulayıcı faktör analizinde elde edilen uyum kriterlerinin puanları kabul edilebilir sınırlar içindedir. Sonuç: DÖB-SOY geçerli ve güvenilir bir ölçüm aracıdır.

Keywords

• Sağlık okuryazarlığı
• Doğum öncesi bakım
• Gebelik
• Metodolojik çalışma

References

1. 1. Renkert S, Nutbeam D. Opportunities to improve maternal health literacy through antenatal education: An exploratory study. Health Promot Int. 2001;16(4):381-8.
2. 2. Mojoyinola J. Influence of maternal health literacy on healthy pregnancy and pregnancy outcomes of women attending public hospitals in Ibadan, Oyo State, Nigeria. Afr. Res. Rev. 2011;5(3).
3. 3. Bick D. National Collaborating Centre for Women’s and Children’s Health. National Institute for Clinical Excellence Caesarean Section Clinical Guideline National Collaborating Centre for Women’s and Children’s Health: commissioned by the National Institute for Clinical Excellence. Worldviews Evid Based Nurs. 2004;1(3):198-9.
4. 4. Villar J, Ba'aqeel H, Piaggio G, Lumbiganon P, Belizán JM, et al. WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. The Lancet. 2001;357(9268):1551-64. DOI: 10.1016/s0140-6736(00)04722-x
5. 5. Republic of Turkey Ministry of Health, Turkey Public Health, Women and Reproductive Health Department, Risk Pregnancy Management Guide 2014.
6. 6. Samur, G. Nutrition During Pregnancy and Lactation, T.C. Ministry of Health Publication, Sinem Press, Ankara. 2008
7. 7. Erkus, A. Writings on Psychometry: Historical Origins of Measurement and Psychometry, Reliability, Validity, Item Analysis, Attitudes; Components and Measurement. 1st edition, Turkish Psychologists Association Publications Ankara. No:24., 2003.
8. 8. Alpar R. Applied statistics with examples from sports, health and education sciences and validity-reliability: Detay Publishing; 2010.

9. 9. Tavsancil E. Measuring attitudes and data analysis with SPSS. Nobel Publishing, Ankara. 2002.
10. 10. Baykul Y. Measurement in education and psychology: Classical test theory and application: OSYM Publications; 2000.
11. 11. Yilmaz V, Celik HE. Structural equation modeling with Lisrel-I: Basic concepts, applications, programming. Ankara: Pegem Academy Publishing; 2009.
12. 12. Ercan I, Ismet K. Reliability and validity in scales. Journal of Uludag University Faculty of Medicine. 2004;30(3):211-6.
13. 13. Erkus A. Writings on Psychometry, Turkish Psychologists Association Publications Ankara. No:24., 2003.
14. 14. Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults. J. Gen. Intern. Med. 1995;10(10):537-41.
15. 15. Yang SJ, Chee YK. Development and psychometric testing of the Health Literacy Index for Female Marriage Immigrants (HLI-FMI) in Korea. Women Health. 2017;57(8):1007-30.
16. 16. Shen M, Hu M, Liu S, Chang Y, Sun Z. Assessment of the Chinese Resident Health Literacy Scale in a population-based sample in South China. BMC Public Health. 2015;15(1):637. DOI 10.1186/s12889-015-1958-0
17. 17. Yang SJ, Chee YK, An J, Park MH, Jung S. Analysis of Validity and Reliability of the Health Literacy Index for Female Marriage Immigrants (HLI-FMI). Asia Pac J Public Health. 2016;28(4):368-81.
18. 18. Hashimoto H, Yanagisawa S. Development of health literacy scale among Brazilian mothers in Japan. Health Promot Int. 2016;32(6):1034-40. DOI: 10.1093/heapro/daw040
19. 19. Pires C, Rosa P, Vigário M, Cavaco A. Short Assessment of Health Literacy (SAHL) in Portugal: development and validation of a self-administered tool. Prim Health Care Res Dev. 2018:1-18. DOI: 10.1017/S1463423618000087
20. 20. Bjørnsen HN, Ringdal R, Espnes GA, Moksnes UK. Positive mental health literacy: development and validation of a measure among Norwegian adolescents. BMC public health. 2017;17(1):717. DOI: 10.1186/s12889-017-4733-6
21. 21. Matsumoto M, Nakayama K. Development of the health literacy on social determinants of health questionnaire in Japanese adults. BMC public health. 2017;17(1):30. DOI: 10.1186/s12889-016-3971-3
22. 22. Yin HS, Sanders LM, Rothman RL, Mendelsohn AL, Dreyer BP, White RO, et al. Assessment of health literacy and numeracy among Spanish-Speaking parents of young children: validation of the Spanish Parental Health Literacy Activities Test (PHLAT Spanish). Acad Pediatr. 2012;12(1):68-74. DOI: 10.1016/j.acap.2011.08.008
23. 23. Ozdemir H, Alper Z, Uncu Y, Bilgel N. Health literacy among adults: a study from Turkey. Health Educ Res. 2010;25(3):464-477. DOI: 10.1093/her/cyp068
24. 24. Bilgel N, Sarkut P, Bilgel H, Ozcakir A. Functional health literacy in a group of Turkish patients: A pilot study. Cogent Soc. Sci. 2017;3(1):1287832. DOI: 10.1080/23311886.2017.1287832
25. 25. Ernstmann N, Halbach S, Kowalski C, Pfaff H, Ansmann L. Measuring attributes of health literate health care organizations from the patients’ perspective: Development and validation of a questionnaire to assess health literacy-sensitive communication (HL-COM). Z Evid Fortbild Qual Gesundhwes. 2017;121:58-63. DOI: 10.1016/j.zefq.2016.12.008
26. 26. Moll S, Zanhour M, Patten SB, Stuart H, MacDermid J. Evaluating Mental Health Literacy in the Workplace: Development and Psychometric Properties of a Vignette-Based Tool. J Occup Rehabil. 2017;27(4):601-11. DOI: 10.1007/s10926-017-9695-0
27. 27. Schreiber JB, Nora A, Stage FK, Barlow EA, King J. Reporting structural equation modeling and confirmatory factor analysis results: A review. J Educ Res. 2006;99(6):323-38. DOI: 10.3200/JOER.99.6.323-338
28. 28. Cokluk O, Sekercioglu G, Büyüköztürk S. Multivariate statistics for social sciences: SPSS and LISREL applications: Pegem Academy; 2012.