Psychometric properties of the Brazilian 14-Item Health Literacy Scale for people living with mental disorders: a cross-sectional study.

INTRODUCTION

There is no evidence of validity and reliability for an instrument capable of comprehensively assessing health literacy (including its Functional, Communicative, and Critical dimensions) among Brazilian adults living with mental disorders.

OBJECTIVE

The aim of this study was to evaluate the validity, reliability, and evidence of divergent validity of the Brazilian 14-Item Health Literacy Scale in individuals with chronic mental disorders.

METHODS

This cross-sectional psychometric study involved patients receiving care at the Psychosocial Care Center in the city of Ijuí, southern Brazil, between April and October 2023. Eligible participants were clinically stable adults with severe and persistent mental disorders; individuals with intellectual disabilities or legal incapacity were excluded. Data collection was conducted by trained students, who read and explained the items of each instrument to the participants. In total, the sample comprised 444 patients. The Brazilian version of the 14-Item Health Literacy Scale, previously translated, cross-culturally adapted, and validated for Brazilian Portuguese, was used to assess health literacy and to perform the psychometric analysis.

RESULTS

Good internal consistency was demonstrated, with Cronbach's alpha and McDonald's omega coefficients of 0.83 (95%CI 0.78-0.88) and 0.75 (95%CI 0.68-0.83), respectively. The 14-Item Health Literacy Scale presented acceptable fit indices for the Comparative Fit Index, Tucker-Lewis Index, and Normed Fit Index, with values of 0.938, 0.923, and 0.904, respectively. Divergent validity was verified by the lack of statistically significant correlations and by weak correlations (r<0.300) with the Social Support Scale.

CONCLUSION

The 14-Item Health Literacy Scale presented adequate psychometric properties and showed evidence of validity and acceptable reliability for assessing the health literacy of Brazilians living with mental disorder.