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Patient Educ Couns. 2014 Nov;97(2):269-75. doi: 10.1016/j.pec.2014.07.024. Epub 2014 Jul 22.

Cross-cultural adaptation and validation of the health literacy assessment tool METER in the Portuguese adult population.

Author information

1
Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal; Monte Murado Health Family Unit, Vila Nova de Gaia, Portugal.
2
Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal.
3
Institute of Social Sciences, University of Lisbon, Lisbon, Portugal.
4
Institute of Preventive Medicine, Faculty of Medicine of Lisbon, Lisbon, Portugal.
5
Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal. Electronic address: anazev@med.up.pt.

Abstract

OBJECTIVE:

We aimed to culturally adapt and validate METER in the Portuguese population, and to define cut-off values for adequate health literacy.

METHODS:

We used the standard procedure for the adaptation of the words and surveyed health professionals to select the non-words. The instrument was administered to a total sample of 249 participants and retested in a sub-sample of 45 after three months. Cut-offs were defined using the modified Angoff procedure. Construct validity was assessed through association with educational attainment and health-related occupation.

RESULTS:

Exploratory factor analysis revealed two dimensions of the instrument, one for words and another for non-words. METER showed a high degree of internal consistency, and acceptable test-retest reliability. Adequate health literacy was defined as scoring at least 35/40 in words and 18/30 in non-words. Physicians scored higher than any other group, followed by health researchers, researchers from other areas and by people with progressively lower levels of education (p<0.001).

CONCLUSION:

We culturally adapted a brief and simple instrument for health literacy assessment, and showed it was valid and reliable.

PRACTICE IMPLICATIONS:

The Portuguese version of METER can be used to assess health literacy in Portuguese adults and to explore associations with health outcomes.

KEYWORDS:

Health literacy; METER; Validation studies

PMID:
25107513
DOI:
10.1016/j.pec.2014.07.024
[Indexed for MEDLINE]

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