Measuring Health Literacy in Childhood and Adolescence with the Scale Health Literacy in School-Aged Children - German Version The Psychometric Properties of the German-Language Version of the WHO Health Survey Scale HLSAC

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  • Saskia M. Fischer
  • Kevin Dadaczynsky
  • Gorden Sudeck
  • Katharina Rathmann
  • Olli Paakkari
  • Leena Paakkari
  • Ludwig Bilz
Health literacy can help explain health inequalities in childhood and adolescence. However, suitable instruments for assessing health literacy in this age group are rare, especially in the German-speaking countries. One economical measure is the 10-item Health Literacy in School-Aged Children (HLSAC) scale, developed and reviewed as part of the WHO Child and Adolescent Health Study (HBSC, Health Behavior in School-Aged Children). In the present study, we tested dimensionality, measurement invariance, and associations with health-related measures of the German version of the scale (HLSAC–German), using data from the 2018 national German HBSC study (N = 4,347 students aged 11, 13, and 15 years). We also tested HLSAC–German with 11-year-olds, representing an expansion of the original scale. Exploratory and confirmatory factor analyses consistently demonstrated the unidimensionality of the scale (α = .88). Complete scalar measurement invariance was found for sex and partial scalar measurement invariance for age groups and school type, allowing for the comparison of means. Associations with indicators of health and health behavior further demonstrate the construct validity of the scale. The analyses show that the scale is suitable for the economic measurement of a general factor of health literacy in 11- as well as in 13- and 15-year-olds.
Translated title of the contributionMessung der Gesundheitskompetenz im Kindes- und Jugendalter mit der Skala „Health Literacy in School-Aged Children-German“ (HLSAC-German). Psychometrische Eigenschaften der deutschsprachigen Version einer Skala aus der WHO Kinder- und Jugendgesundheitsstudie HBSC
Original languageEnglish
Issue number4
Pages (from-to)184-196
Number of pages13
Publication statusPublished - 01.10.2022

Bibliographical note

Publisher Copyright:
© 2022 The Author(s). Distributed as a Hogrefe OpenMind.

    Research areas

  • health literacy, childhood, adolescence, measurement invariance, validity
  • Health sciences