Health literacy scale for English-speaking children: translation and validation of the HLS-Child-Q15-EN.

OBJECTIVE: To translate and validate the HLS-Child-Q15, a relatively short questionnaire for assessing health literacy in children originally validated in German, into English to make it accessible to a large population of English-speaking children. DESIGN: We translated the HLS-Child-Q15 into English following established methods, including forward and backward translation, using multiple translators. We incorporated clinician and consumer input into the translation process. We conducted a qualitative pre-test to assess comprehension and a validation to assess psychometric properties and test-retest reliability. SETTING: Perth Children's Hospital, Perth, Western Australia PATIENTS: We recruited English-speaking children aged 8 to 15 years. MAIN OUTCOME MEASURES: Qualitative analysis of pre-test interviews, Cronbach's α coefficient for internal consistency and intraclass correlation coefficient for test-retest reliability. RESULTS: The translation process yielded an acceptable translation. A qualitative pre-test conducted with 10 children demonstrated good comprehension of questionnaire items and resulted in small changes to increase item clarity. Validation with 207 participants demonstrated that questionnaire output score increased with age, school year, self-efficacy score, parental educational level and home literacy environment score. Internal consistency was assessed, with a Cronbach's α coefficient of 0.854 (95% CI 0.812 to 0.887). Test-retest reliability was moderate, with an intraclass correlation coefficient of 0.612 (95% CI 0.402 to 0.761). CONCLUSIONS: The translated HLS-Child-Q15 was well understood by children. Validation of the translated questionnaire demonstrated adequate psychometric properties, consistent with the original German questionnaire. The translated HLS-Child-Q15 is suitable for use with English-speaking children. DATA AVAILABILITY STATEMENT: Data are available on reasonable request and in compliance with institutional ethics and governance requirements. TRIAL REGISTRATION NUMBER: ACTRN12622001499774.