Validating the Functional, Communicative and Critical Health Literacy Scale Using Rasch Modeling and Confirmatory Factor Analysis
Journal article, Peer reviewed
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Original versionFinbråten HS, Guttersrud Ø, Nordström G, Pettersen KS, Trollvik AT, Larsson BW. Validating the Functional, Communicative and Critical Health Literacy Scale Using Rasch Modeling and Confirmatory Factor Analysis. Journal of Nursing Measurement. 2018;26(2):341-363 http://dx.doi.org/10.1891/1061-3718.104.22.1681
Background and Purpose: The functional, communicative, and critical health literacy (FCCHL) scale is widely used for assessing health literacy (HL) in people with chronic diseases, such as type 2 diabetes (T2DM). Despite related subscales, researchers continue to apply a consecutive modeling approach, treating the three subscales as independent. This article studies the psychometric characteristics of the FCCHL by applying multidimensional modeling approaches. Methods: Rasch modeling and confirmatory factor analyses were applied to responses (paper-and-pencil) from 386 adults with T2DM. Results: Using a six-point rating scale and a three-dimensional Rasch model, this study found that a 12-item version of the FCCHL reduced within-item bias and improved subscale reliability indexes. Conclusion: This study suggests a parsimonious 12-item version of the FCCHL. The data fit a three-dimensional Rasch model best.