Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational study

Abstract Background Health Literacy (HL) is an effective determinant of health and health behaviors. The HL for School-Aged Children (HLSAC) scale has five components, and a 10-item was developed by Paakkari, 2016 in the Finnish language to measure the HL levels of adolescents. However, its validity...

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Main Authors: Popi Rani Bhowmik, K. A. T. M. Ehsanul Huq, Abdulfatai Olamilekan Babaita, Gao Huiying, Michiko Moriyama
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23005-7
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author Popi Rani Bhowmik
K. A. T. M. Ehsanul Huq
Abdulfatai Olamilekan Babaita
Gao Huiying
Michiko Moriyama
author_facet Popi Rani Bhowmik
K. A. T. M. Ehsanul Huq
Abdulfatai Olamilekan Babaita
Gao Huiying
Michiko Moriyama
author_sort Popi Rani Bhowmik
collection DOAJ
description Abstract Background Health Literacy (HL) is an effective determinant of health and health behaviors. The HL for School-Aged Children (HLSAC) scale has five components, and a 10-item was developed by Paakkari, 2016 in the Finnish language to measure the HL levels of adolescents. However, its validity and reliability were not tested among adolescents in the Bengali language. This study aimed to determine the validity and reliability of the HLSAC scale in the Bengali version among adolescents of secondary school children to evaluate their literacy status in Bangladesh. Methods A cross-sectional study was conducted among secondary school children in two different schools in Bangladesh. The schools were purposively selected, one from both rural and urban areas. The participants were students graded between 7 and 9 at the time of enrollment. The validity and reliability of the HLSAC scale were checked by confirmatory factor analysis, convergent validity, Cronbach’s alpha, and test–retest reliability. Results The mean age of the participants was 13.5 years. The reliability of the HLSAC scale showed that Cronbach’s alpha was 0.759. The confirmatory factor analysis model fit appears robust as the p-value was not significant (p = 0.137), 2 /df 1.263, RMSEA 0.029 and CFI = 0.982. The test–retest reliability of this scale was 0.388 (low). For the convergent validity, the Bengali version of the HLSAC scale was positively correlated with the General Self-Efficacy and Perceived Knowledge scales (r = 0.704, 0.618, respectively; all, p < 0.001). Conclusion Our study found that the HLSAC scale, Bengali version is valid and reliable for school-aged adolescents in Bangladesh. This research finding allows for a suitable HLSAC scale to measure the level of HL among adolescents in Bangladesh.
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spelling doaj-art-367a7cfc69004484a85521c3d5176a342025-08-20T03:10:31ZengBMCBMC Public Health1471-24582025-05-0125111310.1186/s12889-025-23005-7Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational studyPopi Rani Bhowmik0K. A. T. M. Ehsanul Huq1Abdulfatai Olamilekan Babaita2Gao Huiying3Michiko Moriyama4Graduate School of Biomedical and Health Sciences, Hiroshima UniversityGraduate School of Biomedical and Health Sciences, Hiroshima UniversityGraduate School of Biomedical and Health Sciences, Hiroshima UniversityGraduate School of Biomedical and Health Sciences, Hiroshima UniversityGraduate School of Biomedical and Health Sciences, Hiroshima UniversityAbstract Background Health Literacy (HL) is an effective determinant of health and health behaviors. The HL for School-Aged Children (HLSAC) scale has five components, and a 10-item was developed by Paakkari, 2016 in the Finnish language to measure the HL levels of adolescents. However, its validity and reliability were not tested among adolescents in the Bengali language. This study aimed to determine the validity and reliability of the HLSAC scale in the Bengali version among adolescents of secondary school children to evaluate their literacy status in Bangladesh. Methods A cross-sectional study was conducted among secondary school children in two different schools in Bangladesh. The schools were purposively selected, one from both rural and urban areas. The participants were students graded between 7 and 9 at the time of enrollment. The validity and reliability of the HLSAC scale were checked by confirmatory factor analysis, convergent validity, Cronbach’s alpha, and test–retest reliability. Results The mean age of the participants was 13.5 years. The reliability of the HLSAC scale showed that Cronbach’s alpha was 0.759. The confirmatory factor analysis model fit appears robust as the p-value was not significant (p = 0.137), 2 /df 1.263, RMSEA 0.029 and CFI = 0.982. The test–retest reliability of this scale was 0.388 (low). For the convergent validity, the Bengali version of the HLSAC scale was positively correlated with the General Self-Efficacy and Perceived Knowledge scales (r = 0.704, 0.618, respectively; all, p < 0.001). Conclusion Our study found that the HLSAC scale, Bengali version is valid and reliable for school-aged adolescents in Bangladesh. This research finding allows for a suitable HLSAC scale to measure the level of HL among adolescents in Bangladesh.https://doi.org/10.1186/s12889-025-23005-7Health LiteracyValidityReliabilityHealth Literacy for School-Aged Children (HLSAC) scaleAdolescents
spellingShingle Popi Rani Bhowmik
K. A. T. M. Ehsanul Huq
Abdulfatai Olamilekan Babaita
Gao Huiying
Michiko Moriyama
Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational study
BMC Public Health
Health Literacy
Validity
Reliability
Health Literacy for School-Aged Children (HLSAC) scale
Adolescents
title Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational study
title_full Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational study
title_fullStr Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational study
title_full_unstemmed Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational study
title_short Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational study
title_sort validity and reliability of health literacy for school aged children hlsac scale to understand the health literacy among adolescents in bangladesh an observational study
topic Health Literacy
Validity
Reliability
Health Literacy for School-Aged Children (HLSAC) scale
Adolescents
url https://doi.org/10.1186/s12889-025-23005-7
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