Cross-cultural adaptation and validation of the Spanish HLS-COVID-Q22 questionnaire for measuring health literacy on covid-19 in Peru

Werner-Masters, Katarzyna ORCID: https://orcid.org/0000-0003-4874-516X, Caipa-Ramos, Manuel Segundo, Quispe-Prieto, Silvia Cristina, Paucar-Cáceres, Alberto and Nina-Chipana, Regina Naty (2025) Cross-cultural adaptation and validation of the Spanish HLS-COVID-Q22 questionnaire for measuring health literacy on covid-19 in Peru. Healthcare. ISSN 2227-9032 (In Press)

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Abstract

Background/Objectives: The social importance of Health Literacy (HL) has been widely understood and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL against COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The diversity of cultures and languages imposes the need for the cross-cultural adaptation of this instrument. Thus, the present study translates, adapts and validates the psychometric properties of the HLS-COVID-Q22 questionnaire to provide its cross-cultural adaptation from English to Spanish (Peru). Methods: As part of ensuring that the final questionnaire accommodates the cultural nuances and idiosyncrasies of the target language: (a) a survey of 40 respondents; and (b) a focus group with 10 participants, followed by expert approval have been completed. In addition, the validity and reliability of the health instrument have been ascertained through a further pilot test administered to 490 people, in the city of Tacna, in southern Peru. Results: The resulting questionnaire helps measure HL in Peru aiding a better-informed decision-making for individual health choices. Conclusions: The presence of such a tool is advantageous in case of similar global health emergencies, when the questionnaire can be made readily available to support a promotion of strategies towards a better self-care. Moreover, it encourages other Latin American stakeholders to adjust the instrument to their own cultural, language and socio-economic ambience, thus invigorating the regional and global expansion of the HL study network.