The Assessment of Structural Validity and Internal Consistency of the Polish Health Literacy Questionnaire (HLQ) in Primary Care Settings.
- 1Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland.
- 2Global Health and Equity Development Hub, La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia.
Abstract
Background/objectives
Health literacy extends beyond individual competencies and encompasses how people engage with health systems. The Health Literacy Questionnaire (HLQ) is a widely used multidimensional instrument designed to assess different health literacy aspects across nine distinct domains. This study aimed to examine structural validity and internal consistency of the Polish version of the HLQ among primary care service users.Methods
The HLQ was used in a cross-sectional survey among 360 adults (mean age 51.76 years, SD 17.48) attending four primary care clinics in Poland. The assessment included confirmatory factor analysis (CFA) and internal consistency tests.Results
A nine-factor CFA model was applied to the HLQ items, without allowing cross-loadings or correlated residuals. The fit indices confirmed good model fit: χ²WLSMV (df = 866) = 1175.63, p < 0.001; CFI = 0.98; TLI = 0.98; RMSEA = 0.038; and SRMR = 0.056. The factor loadings ranged from 0.55 to 0.94, indicating acceptable item-factor relationships across all domains. Internal consistency was satisfactory across all nine domains, with composite reliability ranging from 0.76 to 0.87 and Cronbach's alpha from 0.78 to 0.88.Conclusions
The findings provide preliminary evidence supporting structural validity and internal consistency of the Polish HLQ in this sample of primary care service users and suggest the potential value of the instrument for multi-dimensional assessment of health literacy in similar Polish primary care populations. Future studies should evaluate additional measurement properties of the tool, as well as the performance of the instrument in nationally representative samples and across diverse clinical settings.
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BibTeX
@article{lipiak2026assessment,
title = {{The Assessment of Structural Validity and Internal Consistency of the Polish Health Literacy Questionnaire (HLQ) in Primary Care Settings.}},
author = {Agnieszka Lipiak and Barbara Gawłowska and Marlena Szewczyczak and Monika Karasiewicz and Rafał Staszewski and Richard Osborne and Melanie Hawkins and Ewelina Chawłowska},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14193320},
url = {https://europepmc.org/article/MED/42881759},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Assessment of Structural Validity and Internal Consistency of the Polish Health Literacy Questionnaire (HLQ) in Primary Care Settings.
AU - Agnieszka Lipiak
AU - Barbara Gawłowska
AU - Marlena Szewczyczak
AU - Monika Karasiewicz
AU - Rafał Staszewski
AU - Richard Osborne
AU - Melanie Hawkins
AU - Ewelina Chawłowska
PY - 2026
DA - 2026/10/06
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14193320
UR - https://europepmc.org/article/MED/42881759
AB - Background/objectives Health literacy extends beyond individual competencies and encompasses how people engage with health systems. The Health Literacy Questionnaire (HLQ) is a widely used multidimensional instrument designed to assess different health literacy aspects across nine distinct domains. This study aimed to examine structural validity and internal consistency of the Polish version of the HLQ among primary care service users.Methods The HLQ was used in a cross-sectional survey among 360 adults (mean age 51.76 years, SD 17.48) attending four primary care clinics in Poland. The assessment included confirmatory factor analysis (CFA) and internal consistency tests.Results A nine-factor CFA model was applied to the HLQ items, without allowing cross-loadings or correlated residuals. The fit indices confirmed good model fit: χ²WLSMV (df = 866) = 1175.63, p < 0.001; CFI = 0.98; TLI = 0.98; RMSEA = 0.038; and SRMR = 0.056. The factor loadings ranged from 0.55 to 0.94, indicating acceptable item-factor relationships across all domains. Internal consistency was satisfactory across all nine domains, with composite reliability ranging from 0.76 to 0.87 and Cronbach's alpha from 0.78 to 0.88.Conclusions The findings provide preliminary evidence supporting structural validity and internal consistency of the Polish HLQ in this sample of primary care service users and suggest the potential value of the instrument for multi-dimensional assessment of health literacy in similar Polish primary care populations. Future studies should evaluate additional measurement properties of the tool, as well as the performance of the instrument in nationally representative samples and across diverse clinical settings.
SN - 2227-9032
ER -