Development and initial evaluation of a health literacy assessment for young adult college students

Background: Poor health literacy is related to poor knowledge about health and understanding of one's own health conditions and is associated with poorer health status. The current leading health literacy assessment tools do not assess the entire concept of patient health literacy, and they are not targeted specifically for the young adult population.

College students are currently graduating without the necessary skills needed in the healthcare system today. Research shows that many higher educated individuals still have difficulty understanding and utilizing medical information.

This study presents the content of a new health literacy assessment tool tailored specifically for the 18-24 year-old college student population – that encompasses a more comprehensive measurement of comprehension, numeracy, media literacy, and digital literacy.

Methods: The author created an initial item pool of questions based on research. Health education experts reviewed the initial item pool and helped select the best items that might represent the sub-components of health literacy. This first version of the test was administered to 144 college students. Item Response Theory analysis helped eliminate non-performing items. A second version of the test was administered to 426 college students and analyzed again using Item Response Theory.

Results: Fifty-one items were selected for the test based on good psychometric properties. Good internal consistency (Cronbach's alpha = 0.81).

Conclusions: Framework for new assessment shows promise, but some sections may need more work based on low goodness-of-fit values.