Universität zu Köln

Kowalski, Christoph, Lee, Shoou-Yih D., Schmidt, Anna, Wesselmann, Simone, Wirtz, Markus A., Pfaff, Holger ORCID: 0000-0001-9154-6575 and Ernstmann, Nicole ORCID: 0000-0001-7685-6110 (2015). The health literate health care organization 10 item questionnaire (HLHO-10): development and validation. BMC Health Serv. Res., 15. LONDON: BMC. ISSN 1472-6963

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Abstract

Background: While research on individual health literacy is steadily increasing, less attention has been paid to the context of care that may help to increase the patient's ability to navigate health care or to compensate for their limited health literacy. In 2012, Brach et al. introduced the concept of health literate health care organizations (HLHOs) to describe the organizational context of care. This paper presents our effort in developing and validating an HLHO instrument. Method: Ten items were developed to represent the ten attributes of HLHO (HLHO-10) based on a literature review, an expert workshop, a focus group discussion, and qualitative interviews. The instrument was applied in a key informant survey in 51 German hospitals as part of a larger study on patient information and training needs (PIAT-study). Item properties were analyzed and a confirmatory factor analysis (CFA) was conducted to test the instrument's unidimensionality. To investigate the instrument's predictive validity, a multilevel analysis was performed that used the HLHO-10 score to predict the adequacy of information provided to 1,224 newly-diagnosed breast cancer patients treated at the sample hospitals. Results: Cronbach's a of the resulting scale was 0.89. CFA verified the one-factor structure after allowing for the correlation for four pairs of error terms. In the multilevel model, HLHO-10 significantly predicted the adequacy of information as perceived by patients. Conclusion: The instrument has satisfactory reliability and validity. It provides a useful tool to assess the degree to which health care organizations help patients to navigate, understand, and use information and services. Further validation should include participant observation in health care organizations and a sample that is not limited to breast cancer care.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kowalski, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Lee, Shoou-Yih D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Wesselmann, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Wirtz, Markus A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfaff, Holger UNSPECIFIED orcid.org/0000-0001-9154-6575 UNSPECIFIED Ernstmann, Nicole UNSPECIFIED orcid.org/0000-0001-7685-6110 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-413340
DOI:	10.1186/s12913-015-0707-5
Journal or Publication Title:	BMC Health Serv. Res.
Volume:	15
Date:	2015
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1472-6963
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language IMPROVE COMPREHENSION; INFORMATION; POPULATION; OUTCOMES; PLAN Multiple languages Health Care Sciences & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/41334