Validity and Reliability Evaluation of the Persian Version of the Heart Failure-Specific Health Literacy Scale

Document Type: Original Article


1 Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

2 Department of Anesthesiology, School of Paramedical Sciences, Qom University of Medical Sciences, Qom, Iran

3 Students Research committee, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran

4 Department of Surgery, Nekooei Hedayati Hospital, Qom University of Medical Sciences, Qom, Iran

5 Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria


Background: Health literacy (HL) has important implications for health outcomes in heart failure
(HF) patients. Studying health literacy requires culturally appropriate and valid instruments. The aim
of the study was validation of the Persian version of the heart failure-specific health literacy scale
(HF-Specific HL Scale).
Methods: One hundred patients with heart failure were selected in Qom, Iran in 2017. The ‘forwardbackward’ procedure was applied to translate the questionnaire from English into Persian. Content
validity, face validity, construct validity have been employed to validate the prepared scale. Cronbach’s
alpha coefficients and the test-retest were used to assess the scale reliability. Data were analyzed using
SPSS, version 16, and Smart PLS 3.0 software.
Results: Confirmatory factor analysis completely supported the three-factor model of the HL scales.
Convergent validity was satisfied in that all factor loadings and the average variance extracted
exceeded 0.5. The divergent validity was verified using Fornel and Larcker method. R-square and
path coefficient were higher than 0.43 and 0.65 respectively, indicating the good structural model.
Composite reliability and Cronbach’s α coefficient for all of the constructs were over the recommended
threshold of 0.70, ensuring adequate internal consistency of the scale. The test-retest reliability ranged
from 0.78-0.90, which indicated a good level of stability.
Conclusion: The findings indicated that the Persian HF-specific HL scale is reliable and valid for
measuring health literacy among heart failure patients. Further research is required to measure the
sensitivity and specificity of the scale.





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