Development of a short-form Chinese health literacy scale for low salt consumption (CHLSalt-22) and its validation among hypertensive patients

Abstract

Background: With the accelerated pace of people's life and the changing dietary patterns, the number of chronic diseases is increasing and occurring at a younger age in today's society. The speedily rising hypertensive patients have become one of the main risk factors for chronic diseases. People should focus on health literacy related to salt consumption and reach a better quality of life. Currently, there is a lack of local assessment tools for low salt consumption in mainland China.

Objective: To develop a short-form version of the Chinese Health Literacy Scale For Low Salt Consumption instrument for use in mainland China.

Methods: A cross-sectional design was conducted on a sample of 1472 people in Liaoxi, China. Participants completed a sociodemographic questionnaire, the Chinese version of the CHLSalt-22, the measuring change in restriction of salt (sodium) in the diet in hypertensives (MCRSDH-SUST), the Brief Illness Perception Questionnaire (BIPQ), and the Benefit-Finding Scales (BFS) to test the hypothesis. Exploratory factor analysis and confirmatory factor analyses were performed to examine the underlying factor structure of the CHLSalt-22. One month later, 37 patients who participated in the first test were recruited to evaluate the test-retest reliability.

Results: The CHLSalt-22 demonstrated adequate internal consistency, good test-retest reliability, satisfactory construct validity, convergent validity and discriminant validity. The CHLSalt-22 count scores were correlated with age, sex, body mass index (BMI), education level, income, occupation, the Measuring Change in Restriction of Salt (sodium) in Diet in Hypertensives (MCRSDH-SUST), the Brief Illness Perception Questionnaire (BIPQ), and the Benefit-Finding Scales (BFS).

Conclusion: The results indicate that the Chinese Health Literacy Scale For Low Salt Consumption (CHLSalt-22) version has good reliability and validity and can be considered a tool to assess health literacy related to salt consumption in health screenings.

Keywords: Health literacy; Hypertensive patients; Low salt; Revision and application; Scale.

Fig. 1

Screen plot of exploratory factor analysis for the revised version of the CHLSalt-22

Fig. 2

Standardized seven-factor structural model of the CHLSalt-22 (n = 469); F1 (Functional literacy, 3 items), F2 (Salty food knowledge, 4 items);F3 (Disease knowledge, 3 items), F4 (Myths about salt intake, 3 items);F5 (Salt intake attitudes, 3 items), F6 (Salty food consumption, 3 items);F7 (Nutrition label practices, 3 items)

Fig. 3

The ROC curve of the CHLSalt-22