Skip to main content

Table 2 Single-item characteristics of the HLS-EU-Q47 given various analytical approaches

From: Establishing the HLS-Q12 short version of the European Health Literacy Survey Questionnaire: latent trait analyses applying Rasch modelling and confirmatory factor analysis

    One-dimensional approach Three-dimensional approach Consecutive three-dimensional approach 12-dimensional approach Consecutive 12-dimensional approach
HD CD Item Infit CI t Ordered DIF Infit CI t Ordered DIF Infit CI t DIF
  On a scale from very difficult to very easy, how easy would you say it is to:                 
HC A 1) find information about symptoms of illnesses that concern you? 1.01 0.90 1.10 0.3   Age, y > o 0.98 0.90 1.10 −0.4   Age, y > o 1.03 0.89 1.11 0.6  
A 2) find information on treatments of illnesses that concern you? 0.99 0.90 1.10 −0.3    0.95 0.90 1.10 −1.0    0.99 0.90 1.10 −0.2  
A 3) find out what to do in case of a medical emergency? 1.02 0.91 1.09 0.3    0.97 0.91 1.09 −0.7    1.07 0.90 1.10 1.4  
A 4) find out where to get professional help when you are ill? 0.99 0.89 1.11 −0.1    0.96 0.89 1.11 −0.8    1.06 0.89 1.11 1.1  
B 5) understand what your doctor says to you? 0.96 0.90 1.10 −0.7   Edu, h > l 0.91 0.90 1.10 −1.7   Edu, h > l 0.95 0.90 1.10 −0.9 Edu, h > l
B 6) understand the leaflets that come with your medicine? 1.06 0.90 1.10 1.3    1.04 0.90 1.10 0.9    1.03 0.90 1.10 0.6  
B 7) understand what to do in a medical emergency? 1.00 0.91 1.09 0.1    0.96 0.91 1.09 −0.9    0.99 0.91 1.09 −0.1 Edu, h < l
B 8) understand your doctor’s or pharmacist’s instruction on how to take a prescribed medicine? 0.93 0.89 1.11 −1.3 No   0.89 0.89 1.11 −2.0b No   0.92 0.88 1.12 −1.3  
C 9) judge how information from your doctor applies to you? 0.96 0.89 1.11 −0.6    0.94 0.89 1.11 −1.1    0.96 0.89 1.11 −0.7  
C 10) judge the advantages and disadvantages of different treatment options? 0.96 0.90 1.10 −0.8    0.99 0.90 1.10 −0.2    0.92 0.90 1.10 −1.7  
C 11) judge when you may need to get a second opinion from another doctor? 1.09 0.91 1.09 1.8   Age, y < o 1.14 0.90 1.10 2.7a   Age, y < o Edu, h < l 1.06 0.90 1.10 1.1 Age, y < o
C 12) judge if the information about illness in the media is reliable? 1.16 0.90 1.10 3.1a    1.25 0.90 1.10 4.7a    1.10 0.90 1.10 2.0a  
D 13) use information the doctor gives you to make decisions about your illness? 0.92 0.90 1.10 −1.6   Gen, m > f 0.93 0.90 1.10 −1.4   Gen, m > f 0.93 0.90 1.10 −1.5 Age, y < o
D 14) follow the instructions on medication? 0.98 0.88 1.12 −0.3    0.97 0.88 1.12 −0.5    0.90 0.87 1.13 −1.6  
D 15) call an ambulance in an emergency? 1.07 0.90 1.10 1.4 No Gen, m > f
Age, y > o
1.07 0.90 1.10 1.4 No Gen, m > f
Age, y > o
0.96 0.89 1.11 −0.7 Age, y > o
D 16) follow instructions from your doctor or pharmacist? 0.88 0.89 1.11 −2.1b    0.89 0.89 1.11 −1.9    0.81 0.87 1.13 −2.9b  
DP A 17) find information about how to manage unhealthy behaviour such as smoking, low physical activity and drinking too much? 0.93 0.90 1.10 −1.3   Edu, h > l 0.96 0.90 1.10 −0.7   Edu, h > l 1.06 0.90 1.10 1.2 Edu, h > l
A 18) find information on how to manage mental health problems like stress or depression? 0.95 0.91 1.09 −1.1    1.00 0.91 1.09 0.0    1.18 0.91 1.09 3.5a  
A 19) find information about vaccinations and health screenings that you should have? 0.89 0.91 1.09 −2.3b    0.93 0.91 1.09 −1.4    1.13 0.91 1.09 2.6a  
A 20) find information on how to prevent or manage conditions like being overweight, high blood pressure or high cholesterol? 0.88 0.89 1.11 −2.2b    0.91 0.89 1.11 −1.6    0.96 0.89 1.11 −0.7  
B 21) understand health warnings about behaviour such as smoking, low physical activity and drinking too much? 0.94 0.89 1.11 −1.2 No Edu, h > l 0.94 0.90 1.10 −1.1 No Age, y > o Edu, h > l 0.90 0.89 1.11 −1.7  
B 22) understand why you need vaccinations? 1.01 0.90 1.10 0.3   Age, y > o 1.03 0.90 1.10 0.6   Age, y > o 1.01 0.90 1.10 0.1 Educ
B 23) understand why you need health screenings? 0.94 0.89 1.11 −1.0    0.97 0.89 1.11 −0.5   Age, y > o 0.91 0.89 1.11 −1.5  
C 24) judge how reliable health warnings are, such as smoking, low physical activity and drinking too much? 0.99 0.90 1.10 −0.1    1.01 0.90 1.10 0.2    1.06 0.90 1.10 1.2 Age, y > o
C 25) judge when you need to go to a doctor for a check-up? 0.98 0.91 1.09 −0.4   Age, y < o 1.03 0.91 1.09 0.7   Age, y < o Edu, h < l 1.00 0.91 1.09 0.1 Age, y < o Edu, h < l
C 26) judge which vaccinations you may need? 1.03 0.91 1.09 0.7    1.05 0.91 1.09 1.0    1.06 0.91 1.09 1.2  
C 27) judge which health screenings you should have? 0.92 0.91 1.09 −1.9   Age, y < o 0.94 0.91 1.09 −1.4   Age, y < o 0.92 0.91 1.09 −1.8 Age, y < o
C 28) judge if the information on health risks in the media is reliable? 1.03 0.90 1.10 0.6    1.05 0.90 1.10 1.0    1.02 0.90 1.10 0.4 Age, y > o
D 29) decide if you should have a flu vaccination? 1.18 0.91 1.09 3.6a   Age, y < o 1.24 0.91 1.09 4.7a   Age, y < o 1.06 0.91 1.09 1.3 Age, y < o
D 30) decide how you can protect yourself from illness based on advice from family and friends? 1.06 0.91 1.09 1.3    1.12 0.91 1.09 2.5a   Edu, h < l 1.00 0.91 1.09 0.0 Age, y > o
Edu, h < l
D 31) decide how you can protect yourself from illness based on information in the media? 0.98 0.91 1.09 −0.3    1.01 0.91 1.09 0.3    0.93 0.91 1.09 −1.5  
HP A 32) find information on healthy activities such as exercise, healthy food and nutrition? 0.96 0.90 1.10 −0.7    0.96 0.90 1.10 −0.8    0.95 0.90 1.10 −1.0  
A 33) find out about activities that are good for your mental well-being? 0.97 0.90 1.10 −0.6    0.93 0.90 1.10 −1.3    0.93 0.90 1.10 −1.5 Gen, m < f
A 34) find information on how your neighbourhood could be more health-friendly? 1.04 0.90 1.10 0.8    1.01 0.90 1.10 0.2    0.98 0.90 1.10 −0.4  
A 35) find out about political changes that may affect health? 1.10 0.90 1.10 1.8    1.08 0.90 1.10 1.5    1.06 0.89 1.11 1.0  
A 36) find out about efforts to promote your health at work? 1.02 0.91 1.09 0.3    1.02 0.91 1.09 0.5    1.02 0.91 1.09 0.3  
B 37) understand advice on health from family members or friends? 1.06 0.90 1.10 1.2   Age, y > o 1.07 0.90 1.10 1.4   Age, y > o 1.06 0.90 1.10 1.1 Age, y > o
B 38) understand information on food packaging? 1.12 0.91 1.09 2.5a    1.16 0.91 1.09 3.3a   Age, y > o 1.12 0.91 1.09 2.5a Gen, m > f
B 39) understand information in the media on how to get healthier? 0.97 0.90 1.10 −0.7    0.97 0.90 1.10 −0.7    0.96 0.90 1.10 −0.8  
B 40) understand information on how to keep your mind healthy? 0.91 0.91 1.09 −2.0b    0.89 0.91 1.09 −2.3b    0.93 0.91 1.09 −1.4 Age, y < o
C 41) judge how where you live affects your health and well-being? 1.01 0.90 1.10 0.3   Age, y < o 0.97 0.90 1.10 −0.5   Age, y < o 1.02 0.9 1.10 0.4  
C 42) judge how your housing conditions help you to stay healthy? 0.99 0.90 1.10 −0.2   Age, y < o 0.96 0.90 1.10 −0.9   Age, y < o 0.99 0.9 1.10 −0.3 Edu, h < l
C 43) judge which everyday behaviour is related to health? 0.92 0.89 1.11 −1.5    0.90 0.89 1.11 −1.8    1.15 0.89 1.11 2.5a Age, y > o
Edu, h > l
D 44) make decisions to improve your health? 1.06 0.91 1.09 1.3    1.00 0.91 1.09 0.0    0.99 0.91 1.09 −0.1  
D 45) join a sports club or exercise class if you want to? 1.12 0.90 1.10 2.3a    1.06 0.90 1.10 1.3    1.01 0.90 1.10 0.2  
D 46) influence your living conditions that affect your health and well-being? 1.05 0.91 1.09 1.0    0.98 0.91 1.09 −0.3    1.01 0.91 1.09 0.2 Age, y > o
D 47) take part in activities that improve health and well-being in your community? 1.10 0.91 1.09 2.0a    1.04 0.91 1.09 0.8    1.04 0.90 1.10 0.9  
  1. Note. This table reports the item-fit indexes after applying the one-dimensional (subscale correlation fixed to 1), three-dimensional and 12-dimensional approaches (treating the subscales as correlated). The analyses of the ordering of response categories (ordered) and differential item functioning (DIF) are based on the one-dimensional and consecutive approaches (treating the subscales as orthogonal or uncorrelated) for the three health domains and the 12 subscales. Ordered: “No” refers to an item with unordered response categories
  2. aA t–value > 1.96 and an infit-value > 1 indicate a poor fit with the Rasch model due to there being more variation in the data than was expected by the model (item is under-discriminating)
  3. bA t–value <−1.96 and an infit-value < 1 indicate a poor fit with the Rasch model due to there being less variation in the data than was expected by the model (item is over-discriminating)
  4. For items displaying uniform DIF, the relevant dichotomized person factor levels are indicated. For example, “Age, y > o” refers to a uniform DIF for the person factor age in favour of the y = younger respondents (47 years or younger) factor level compared to the o = older respondents (48 years or older) factor level. The “Highest completed education level” (Edu) factor has l = low (primary and secondary school) and h = high (university or university college) levels, and the “Gender” factor (Gen) has the f = females and m = males levels
  5. cnon-uniform DIF (item 22). All other DIFs were uniform
  6. A: access, B: understand, C: appraise, CD: cognitive domain, CI: confidence interval, D: apply, DP: disease prevention, HC: healthcare, HD: health domain, HP: health promotion
  7. RUMM2030 was used for the analyses of the ordering of response categories and DIF. ConQuest 4 was used for all other analyses