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. 2019 Mar 11;16(5):881.
doi: 10.3390/ijerph16050881.

Development and Validation of an Environmental Health Literacy Assessment Screening Tool for Domestic Well Owners: The Water Environmental Literacy Level Scale (WELLS)

Veronica L Irvin  1 , Diana Rohlman  2 , Amelia Vaughan  3 , Rebecca Amantia  4 , Claire Berlin  5 , Molly L Kile  6
Affiliations

Development and Validation of an Environmental Health Literacy Assessment Screening Tool for Domestic Well Owners: The Water Environmental Literacy Level Scale (WELLS)

Veronica L Irvin et al. Int J Environ Res Public Health. .

Abstract

In the U.S., privately owned wells are not subject to any regulatory testing requirements. Well owners must have sufficient environmental health literacy (EHL) to understand and interpret information that contain complex terms and labels to manage their water quality. The objective of this paper is to assess the performance and validity of a new EHL screening tool. The Water Environmental Literacy Level Scale (WELLS) is based on the Newest Vital Sign (NVS) and contains six questions on comprehension, calculations and application of information. Content validity was assessed from expert review. Criterion-related and construct validity were evaluated using an online, convenience sample of adults (n = 869). Percent of correct responses for items ranged from 53% to 96% for NVS and from 41% to 97% for WELLS. Completion time, mean scores, distributions, and internal consistency were equivalent between both scales. Higher scores suggest higher EHL. The scales were moderately correlated (ρ = 0.47, p < 0.001). Kappa agreement was 74%. Bland-Altman plots depicted little mean difference between the scales. Education and income level were positively associated with EHL. WELLS showed criterion-validity with NVS and construct validity with education and income. In practice or research, WELLS could quickly screen individuals for low EHL.

Keywords: domestic well; environment; health literacy; scale development; scale diagnostics; water.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Location of the MTurk respondents.
Figure A2
Figure A2
Histograms of total correct scores for the Newest Vital Sign (top figure, (a)) and the Water Environmental Literacy Level Scale (bottom figure, (b)).
Figure A2
Figure A2
Histograms of total correct scores for the Newest Vital Sign (top figure, (a)) and the Water Environmental Literacy Level Scale (bottom figure, (b)).
Figure A3
Figure A3
Scree plot of eigenvalues following the factor analysis of the NVS (left-hand side, (a)) and WELLS (right-hand side, (b)) scales.
Figure 1
Figure 1
Visual aid used in Water Environmental Literacy Level Scale (WELLS).
Figure 2
Figure 2
Bland-Altman plot analyzing the agreement between Newest Vital Signs and Water Environmental Literacy Level Scale (WELLS).
See this image and copyright information in PMC

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