Measuring adolescent health literacy in Nigeria: psychometric validation of the health literacy assessment scale for adolescents

Abstract

The Health Literacy Measure for Adolescents (HELMA) is a multidimensional tool used to measure health literacy in adolescents. Previous studies on adolescent health literacy were primarily hospital-based, and the instruments used did not encompass all domains of health literacy. This descriptive cross-sectional study aimed to validate the HELMA questionnaire in secondary schools located in a rural and an urban local government area (LGA) of Osun State, Nigeria. The Health Literacy Measure for Adolescents (HELMA) tool was validated among 430 adolescents selected using a four-stage sampling technique from Junior and Senior Secondary Schools located in rural and urban local government areas (LGA) of Osun State, Nigeria. Psychometric properties of the tool were assessed using Cronbach’s alpha and inter-item correlation. The adolescents were 13.5 ± 2.4 years old, and 50.7% were female. The Health Literacy Measure for Adolescents showed moderate to good psychometric properties. CFA showed good fit indices for an eight-factor model. The Cronbach’s alpha coefficient ranged from 0.73 to 0.89 for the various constructs. The intra-rater consistency, assessed by the intra-class correlation coefficient, was 0.93 (0.65–0.89), indicating good test-retest reliability. This study provides support for the use of the HELMA as a valid and reliable instrument to measure health literacy in adolescents in Nigeria. The Health Literacy Measure for Adolescents (HELMA) is a valid and reliable tool for measuring the health literacy of adolescents aged 10–19 and can evaluate different levels of functional, interactive, and critical health literacy.