Vietnamese version of the Health Literacy Questionnaire: translation, linguistic validation, and assessment of cross-cultural adaptation

Abstract

Health literacy (HL) is a fundamental factor in raising health awareness and self-management, especially in contexts with increasingly complicated health systems. Its accurate and culturally appropriate measurement is necessary to support effective medical interventions. Accordingly, we translated the Health Literacy Questionnaire (HLQ) into Vietnamese and analysed its psychometric properties on the basis of data derived from respondents who completed the translated instrument. A cross-sectional study was performed with 585 residents (average age = 40.9 (SD = 14.7; youngest = 19 years old, oldest = 81 years old) of Ho Chi Minh City in December 2024. A reliability analysis showed that the Vietnamese HLQ had good reliability (Cronbach's alpha = 0.75 to 0.86). A nine-factor model was constructed using 44 items from the questionnaire, after which it was subjected to confirmatory factor analysis to determine its fit under the assumption that no correlated residuals or cross-loadings exist. The fit indices satisfied the cut-offs [χ2 (weighted least squares mean and variance) (866) = 2545.77, P < 0.001, CFI = 0.931, TLI = 0.924, RMSEA = 0.058, SRMR = 0.053], but the effects are less distinctive with regard to scales 6-9 (e.g. engagement with healthcare providers, understanding of health information). The results provide a solid scientific basis for using the questionnaire in research and practice. Its application is key to improving understanding of and access to community health information.

Keywords: HLQ; Health Literacy Questionnaire; Vietnam; cross-cultural adaptation; linguistic validation; psychometric properties.