Coping with heat: exploring psychometric properties and relationships of a heat-related health literacy scale

Climate change and rising temperatures are increasingly threatening public health, underscoring the need for effective strategies to manage heat-related risks. Promoting heat-related health literacy (HRHL) is crucial, yet no validated scale exists to measure it. We developed a 20-item HRHL scale and tested it in a cross-sectional survey of 407 adults in Germany (50.6% female, M = 58.0, SD = 12.0 years). The scale was tested using exploratory structural equation modeling with a bootstrapping approach and reduced to 16 items (Cronbach's alpha = 0.96). A four-factor structure (finding, understanding, appraising, and applying heat-related health information) with a higher first-order factor with good fit indices (CFI = 0.97, TLI = 0.96, RMSEA = 0.06, SRMR = 0.03) was found. About 36% of respondents reported inadequate or problematic HRHL. The scale showed small but significant associations between understanding/appraising and heat wave knowledge, while all HRHL factors were moderately related to heat wave practice and behavior. The newly developed scale, which has been tested for its psychometric properties, can be used as a basis for epidemiological studies. It would subsequently allow the relationships between the targeted health behavior and constructs, such as heat-related practices and behaviors, to be further substantiated.