Experiences of the Development of a Revised, Population-Adjusted Communicative Health Literacy Scale.

The first project of the Action Network on Measuring Population and Organizational Health Literacy was the Health Literacy Population Survey 2019-2021 (HLS19). Based on the HLS19's experience, improvements were needed to the communicative health literacy questionnaire before it could be used in the second wave of the HLS survey. Our aim was to test the comprehensibility of the Hungarian version of the revised questionnaire with cognitive interviews. Two questions caused comprehension problems: (1) discussing health information with your doctor from other sources such as internet, family and friends-participants found this question too long and difficult, so we changed the sentence structure to make it more understandable; (2) expressing personal views and preferences to your doctor-the interviewees misunderstood the question, they did not realize that we were referring to health-related personal views. During the translation process, it was challenging to convey the meaning of "health concern" in Hungarian, the version with examples in parentheses was deemed the most effective. The final version of the revised questionnaire seemed to be understandable and comprehensible.