Development of the Musicians’ Health Literacy Questionnaire (MHL-Q19)

Musicians have long suffered compromised wellbeing and high rates of health<br/>problems associated with their occupation, such as musculoskeletal injuries,<br/>hearing problems, neurological conditions, and mental-health issues. Over the<br/>past three decades, a substantial amount of research on performance-related<br/>health issues (PRHIs) in musicians has emerged, including numerous studies<br/>focused on health-promotion strategies to help prevent PRHIs. However, despite<br/>this extensive body of literature, high rates of preventable physical and<br/>psychological health problems in musicians are still reported. This may be<br/>explained, in part, by the fact that many musicians are ill-equipped to identify and<br/>deal with PRHIs as health concerns, considering them instead as a normal part of<br/>their music learning, practice, or performance. Research shows that people’s<br/>health literacy—their ability to access, understand, appraise and apply health<br/>information—plays a major role in their health outcomes, and that situational<br/>demands and context-dependent factors are important determinants of health.<br/>This paper explores the concept of occupational health literacy (OHL) and its<br/>applicability to musicians, arguing the need for an occupation-specific tool to<br/>assess musicians’ health literacy (MHL). It describes the process of designing and<br/>developing the English-language version of the Musicians’ Health Literacy<br/>Questionnaire (MHL-Q19), a musician-specific HL measure developed by an<br/>interdisciplinary group of musicians’ health experts and modelled on the<br/>conceptual framework and development process of the European Health Literacy<br/>Survey (HLS-EU). The results of a separate validation study for the MHL-Q19,<br/>carried out in an international population of tertiary music students, found that MHL<br/>is a distinct construct and revealed a relationship between lower levels of MHL and<br/>higher rates of PRHIs in student musicians, confirming the need for this MHL<br/>assessment tool. Because MHL may influence musicians’ health-promoting<br/>behaviours in relation to the specific occupational health risks they face,<br/>investigating MHL can yield new understanding that will help to inform and<br/>enhance strategies to prevent PRHIs. The translatability of the MHL-Q19 follows<br/>that of the HLS-EU model, opening the way to future investigation of MHL in global<br/>populations of musician to address this gap in knowledge. The development<br/>process described in this paper provides a model for development of OHL<br/>assessment tools for use in other domains of performing arts health research.<br/><br/>