Development of a New Survey Instrument to Measure Professional Health Literacy

BACKGROUND: Health professionals (HPs) can play a central role in strengthening their patients' health literacy (HL), provided they possess the necessary skills and work in an HL-friendly organizational environment. However, large-scale empirical studies have not yet examined the extent to which HPs are able to enhance patients' HL or the key challenges they encounter in doing so. This gap is largely due to the lack of a clear conceptualization of professional HL and the absence of an appropriate measurement instrument. OBJECTIVE: The aim of this study was to develop a questionnaire to measure HPs' professional HL, based on a new conceptualization of professional HL, and to test its factorial validity in a diverse group of HPs. METHODS: The Professional Health Literacy Questionnaire (PROF-HL-Q) was developed to assess HPs' professional HL. It was tested using a stepwise procedure involving national samples of two to four health professions (physicians, nurses, physiotherapists, and pharmacists) across three countries. The professional HL surveys were administered online between May 2022 and August 2022 in Austria (n = 3,876), Germany (n = 921), and Switzerland (n = 1,613). Exploratory and confirmatory factor analyses were conducted to evaluate the questionnaire' factorial validity. Internal consistency was assessed using Cronbach's alpha, ordinal alpha, omega, and the average variance extracted. KEY RESULTS: The PROF-HL-Q, comprising 34 items, proved to be a valid instrument for capturing and distinguishing the four core domains of professional HL, demonstrating factorial validity and internal consistency. The findings were highly consistent across the countries and health professions included in the study. CONCLUSIONS: The PROF-HL-Q can be used in representative surveys and evaluation studies to identify challenges and monitor progress in strengthening HPs' professional HL. Data on professional HL can help determine where measures are needed to enhance HPs' skills, improve professional training, and make health care organizations more HL-friendly.