1. SUITABILITY OF SHORT VERSIONS OF HLS-EU IN MALAYSIAN POPULATION: A COMPARISON BETWEEN HLS-EU 16 AND HLS-EU 12 Karuthan Chinna Centre for Education and Population Health University Malaya Malaysia

2. HEALTH LITERACY DEFINITION
Health literacy is linked to literacy and entails people’s knowledge
motivation and competences to…
Access
Understand
Appraise
Apply health information
in order to make judgments and take decisions in everyday life
Concerning…
Healthcare
Disease prevention
Health promotion
to maintain or improve quality of life during the life course
(Sorensen, K et al )

3. THE CONCEPTUAL MODEL

4. Understand Information
THE MATRIX
Obtain/ Access
Information
Understand Information
Process/
Appraise Information
Apply/
Use
Health Care
(HC)
Disease Prevention (DP)
Health Promotion (HP)

5. HLS-EU 16

6. Understand Information
HLS-EU 16
Obtain/ Access
Information
Understand Information
Process/
Appraise Information
Apply/
Use
Health Care
(HC)
2 items
1 item
Disease Prevention (DP)
Health Promotion (HP) -

7. Understand Information
HEALTH CARE (HC)
Obtain/
Access
Information
Q1 Find information on treatments of illnesses that
concern you
Q2 Find out where to get professional help when you
are ill
Understand Information
Q3 Understand what your doctor says to you
Q4 Understand your doctor’s or pharmacist’s
instruction on how to take a prescribed medicine
Process/
Appraise Information
Q5 Judge when you may need to get a second opinion
from another doctor
Apply/
Use
Q6 Use information the doctor gives you to make
decisions about your illness
Q7 Follow instructions from your doctor or pharmacist

8. DISEASE PREVENTION (DP)
Obtain/
Access
Information
Q8 Find information on how to manage mental health
problems like stress or depression
Understand Information
Q9 Understand health warnings about behavior such
as smoking, low physical activity and drinking
Q10 Understand why you need health screenings
Process/
Appraise Information
Q11 Judge if the information on health risks in the
media is reliable
Apply/
Use
Q12 Decide how you can protect yourself from illness
based on information in the media

9. Understand Information
HEALTH PROMOTION (HP)
Obtain/
Access
Information
Q13 Find out about activities that are good for your
mental well-being
Understand Information
Q14 Understand advice on health from family
members or friends
Q15 Understand information in the media on how to
get healthier
Process/
Appraise Information
Q16 Judge which everyday behavior is related to your
health
Apply/
Use _

10. HLS-EU 12

11. Understand Information
HLS-EU 12
Obtain/ Access
Information
Understand Information
Process/
Appraise Information
Apply/
Use
Health Care
(HC)
1 item
Disease Prevention (DP)
Health Promotion (HP)

12. Understand Information
HEALTH CARE (HC)
Obtain/
Access
Information
Q1 Find information on treatments of illnesses that
concern you
Understand Information
Q2 Understand the leaflets that come with your
medicine
Process/
Appraise Information
Q3 Judge the advantages and disadvantages of
different treatment options?
Apply/
Use
Q4 Call an ambulance in an emergency

13. DISEASE PREVENTION (DP)
Obtain/
Access
Information
Q5 Find information on how to manage mental health
problems like stress or depression
Understand Information
Q6 Understand why you need health screenings
Process/
Appraise Information
Q7 Judge which vaccinations you may need
Apply/
Use
Q8 Decide how you can protect yourself from illness
based on information in the media

14. Understand Information
HEALTH PROMOTION (HP)
Obtain/
Access
Information
Q9 Find out about activities that are good for your
mental well-being
Understand Information
Q10 Understand information in the media on how to
get healthier
Process/
Appraise Information
Q11 Judge which everyday behavior is related to
your health
Apply/
Use
Q12 Join a sports club or exercise class if you want to

15. METHODOLOGY POPULATION:
MALAYSIANS WHO MAKE DECISIONS ON OWN / FAMILY HEALTH
SAMPLE DESIGN
QUOTA SAMPLING
SAMPLE
n= 600: MALAYs, 200 CHINESE, 200 INDIANS
ADMINISTRATION:
SELF-ADMINISTERED
SHORT VERSIONS HLS-16 AND HLS-12

16. SOME RESULTS

17. INTERNAL CONSISTENCIES
Cronbach’s a values from reliability analyses
DOMAIN
HSL-16
HLS-12
HEALTHCARE (HC)
0.779
0.454
DISEASE PREVENSION (DP)
0.775
0.700
HEALTH PROMOTION (HP)
0.795
0.737

18. HLS-EU 16 Fit indices Chi-square = 266.8 df = 101 p=.000
GFI = AGFI = .923
CFI = TLI= .941
RMSEA = .052
r=0.92

19. CONVERGENT & DISCRIMINANT VALIDITIES OF HLS-16
Convergent Validity
Discriminant validity CR
AVE DP HC HP
0.775
0.408
0.801
0.367
0.696
0.797
0.496
0.837
0.646
CR > 0.7 & > AVE
BUT FOR HC, AVE IS LOW
DIAGONALS ARE AVEs
OFF DIAGONALS ARE R-SQUARES
IDEALLY FOR DISCRIMINANT VALIDITY,
R-SQUARES MUST BE < AVEs

20. HLS-EU 12 Fit indices Chi-square = 91.558 df = 51 p=.000
GFI = AGFI = .34
CFI = TLI= .970
RMSEA = .036
r=0.97
r=0.93

21. CONVERGENT & DISCRIMINANT VALIDITIES OF HLS-12
Convergent Validity
Discriminant validity CR
AVE DP HC HP
0.743
0.422
0.539
0.238
0.608
0.699
0.368
0.857
0.942
CR > 0.7 & > AVE
BUT FOR HC, AVE IS LOW
DIAGONALS ARE AVEs
OFF DIAGONALS ARE R-SQUARES
IDEALLY FOR DISCRIMINANT VALIDITY,
R-SQUARES MUST BE < AVEs

22. COMPARISON OF CONVERGENT VALIDITIES
HLS-16
HLS-12 CR
AVE DP
0.775
0.408
0.743
0.422 HC
0.801
0.367
0.539
0.238 HP
0.797
0.496
0.699
0.368
Convergence of the items in the domains of HLS-16
is better compared to those in HLS-12

23. COMPARISON OF DISCRIMINANT VALIDITIES
HLS-16 DP HC HP
0.408
0.696
0.367
0.837
0.646
0.496
HLS-12 DP HC HP
0.422
0.608
0.238
0.857
0.942
0.368
Discriminance between domains in HLS-16
is better compared to HLS-12

24. CONCLUSION
HLS-EU 16 seems to fit better in Malaysian context compared to the HLS-T 12