Womens Health Nurs.  2024 Dec;30(4):330-339. 10.4069/whn.2024.10.18.

Validity and reliability of the Turkish version of the Maternal Health Literacy Inventory in Pregnancy scale: a methodological study

Affiliations
  • 1Department of Obstetrics and Gynaecology, Istanbul Florence Nightingale Hospital, Istanbul, Turkiye
  • 2Department of Nursing, Faculty of Health Sciences, Yeditepe University, Istanbul, Turkiye

Abstract

Purpose
This study aimed to translate the Maternal Health Literacy Inventory in Pregnancy (MHELIP) scale into Turkish and evaluate its validity and reliability for use in the Turkish population. Methods: The participants in this methodological study included 250 pregnant women who presented to the antenatal clinic of the Florence Nightingale Hospital in Istanbul, Turkiye. Content validity was assessed using expert approval. Confirmatory factor analysis, exploratory factor analysis, and structural equation modeling were used to assess the validity. Criterion validity was evaluated using the shortform health literacy survey tool, the Short-Form Health Literacy Questionnaire (HLS-SF12). To assess reliability, Cronbach’s alpha, item analysis, and the test-retest method were used. Results: The mean age of the participants was 32.02±4.15 years. The content validity index of the scale was .99. The scale had a four-factor structure that fit well with 48 items. “Maternal health knowledge,” “maternal health information search,” “maternal health information assessment,” and “maternal health decision making and behavior” subscales had Cronbach’s alpha values of .91, .76, .85, and .90, respectively. The MHELIP and HLS-SF12 scores were significantly correlated (r=.422, p<.001). Conclusion: The MHELIP was found to be a valid and reliable measurement tool in pregnant Turkish women.

Keyword

Literacy; Health literacy; Pregnancy; Pregnant women; Validity and reliability

Figure

  • Figure 1. Path diagram.


Reference

References

1. Davis EP, Narayan AJ. Pregnancy as a period of risk, adaptation, and resilience for mothers and infants. Dev Psychopathol. 2020; 32(5):1625–1639. https://doi.org/10.1017/S0954579420001121.
Article
2. World Health Organization (WHO). WHO recommendations on antenatal care for a positive pregnancy experience [Internet]. Geneva: Author;2016. [cited 2024 Jan 19]. Available from: https://www.who.int/publications/i/item/9789241549912.
3. Taheri S, Tavousi M, Momenimovahed Z, Direkvand-Moghadam A, Tiznobaik A, Suhrabi Z, et al. Development and psychometric properties of maternal health literacy inventory in pregnancy. PLoS One. 2020; 15(6):e0234305. https://doi.org/10.1371/journal.pone.0234305. DOI: 10.1371/journal.pone.0234305. PMID: 32525889.
Article
4. Sørensen K, Pelikan JM, Röthlin F, Ganahl K, Slonska Z, Doyle G, et al. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health. 2015; 25(6):1053–1058. https://doi.org/10.1093/eurpub/ckv043. DOI: 10.1093/eurpub/ckv043. PMID: 25843827.
Article
5. Ezadi Z, Lamyian M, Montazeri A. Health literacy level of primiparous women with postpartum depression attending to Kabul hospitals, Afghanistan. Health Monit J Iranian Inst Health Sci Res. 2021; 20(5):599–608. https://doi.org/10.52547/payesh.20.5.599. DOI: 10.52547/payesh.20.5.599.
Article
6. Mojoyinola JK. Influence of maternal health literacy on healthy pregnancy and pregnancy outcomes of women attending public hospitals in Ibadan, Oyo State, Nigeria. Afr Res Rev. 2011; 5(3):28–39. https://doi.org/10.4314/afrrev.v5i3.67336. DOI: 10.4314/afrrev.v5i3.67336.
Article
7. Yee LM, Silver R, Haas DM, Parry S, Mercer BM, Wing DA, et al. Association of health literacy among nulliparous individuals and maternal and neonatal outcomes. JAMA Netw Open. 2021; 4(9):e2122576. https://doi.org/10.1001/jamanetworkopen.2021.22576. DOI: 10.1001/jamanetworkopen.2021.22576. PMID: 34468757.
Article
8. Audritsh NL. Measuring the impact of health literacy on perinatal depression. Adv Fam Pract Nurs. 2022; 4(1):159–172. DOI: 10.1016/j.yfpn.2021.12.010.
Article
9. Alinejad-Naeini M, Razavi N, Sohrabi S, Heidari-Beni F. The association between health literacy, social support and self-efficacy in mothers of preterm neonates. J Matern Fetal Neonatal Med. 2021; 34(11):1703–1710. https://doi.org/10.1080/14767058.2019.1644620. DOI: 10.1080/14767058.2019.1644620. PMID: 31307262.
Article
10. Safari Morad Abadi A, Agha Molaei T, Ramezankhani A, Dadipoor S. The health literacy of pregnant women in Bandar Abbas, Iran. J Sch Public Health Inst Public Health Res. 2017; 15(2):121–132. https://doi.org/10.1016/j.yfpn.2021.12.010. DOI: 10.1016/j.yfpn.2021.12.010.
Article
11. Kohan S, Ghasemi S, Dodangeh M. Associations between maternal health literacy and prenatal care and pregnancy outcome. Iran J Nurs Midwifery Res. 2007; 12(4):146–152.
12. Durusu Tanrıover M, Yıldırım HH, Demiray FN, Çakır B, Akalın HE. Turkiye health literacy survey. Ankara: Saglık-Sen Publication;2014.
13. Şirin Gök M, Küçük K, Kanbur A. Examination of the relationship between health literacy and health practices of pregnant women. STED. 2022; 31(6):409–417. https://doi.org/10.17942/sted.1021910. DOI: 10.17942/sted.1021910.
Article
14. Korkmaz Aslan G, Kılınç İşleyen E, Kartal A, Koştu N. The relation between eHealth literacy and healthy lifestyle behaviours in pregnant women. Health Promot Int. 2024; 39(2):daae022. https://doi.org/10.1093/heapro/daae022. DOI: 10.1093/heapro/daae022. PMID: 38501310.
Article
15. Guler DS, Sahin S, Ozdemir K, Unsal A, Uslu Yuvacı H. Health literacy and knowledge of antenatal care among pregnant women. Health Soc Care Community. 2021; 29(6):1815–1823. https://doi.org/10.1111/hsc.13291. DOI: 10.1111/hsc.13291. PMID: 33484046.
Article
16. Yeşilçınar İ, Şahin E, Mercan D. Investigation of the relationship between health literacy and the traditional practices of women who were in the postpartum period. TJFMPC. 2021; 15(3):594–601. https://doi.org/10.21763/tjfmpc.865926. DOI: 10.21763/tjfmpc.865926.
Article
17. Aras Z, Bayik Temel A. Evaluation of validity and reliability of the Turkish version of Health Literacy Scale. Florence Nightingale Hem Derg. 2017; 25(2):85–94. https://doi.org/10.17672/fnhd.9462. DOI: 10.17672/fnhd.9462.
Article
18. Karahan Yılmaz S, Eskici G. Validity and reliability study of the Turkish form of the Health Literacy Scale-Short Form and Digital Healthy Diet Literacy Scale. Izmir Katip Celebi Univ Saglik Bilim Fak Derg. 2021; 6(3):19–25.
19. Bahar Özvarış Ş, Güçiz Doğan B, Konşuk Ünlü H, et al. The adaptation of Turkish health literacy scale for literate Syrian adult refugees living in Turkiye: a reliability-validity study. Confl Health. 2021; 15(1):65. https://doi.org/10.1186/s13031-021-00401-5. DOI: 10.1186/s13031-021-00401-5. PMID: 34454560.
Article
20. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008; 61(4):344–349. https://doi.org/10.1016/j.jclinepi.2007.11.008. DOI: 10.1016/j.jclinepi.2007.11.008. PMID: 18313558.
Article
21. DeVellis RF, Thorpe CT. Scale development: theory and applications. 5th ed. Thousand Oaks (CA): Sage Publications;2021.
22. Çapık C, Gözüm S. Intercultural scale adaptation stages, language and culture adaptation: updated guideline. Florence Nightingale J Nurs. 2018; 26:199–210. https://doi.org/10.26650/FNJN397481. DOI: 10.26650/FNJN397481.
Article
23. Duong TV, Aringazina A, Kayupova G, Pham TV, Pham KM, et al. Development and validation of a new Short-Form Health Literacy Instrument (HLS-SF12) for the general public in six Asian countries. Health Lit Res Pract. 2019; 3(2):e91–e102. https://doi.org/10.3928/24748307-20190225-01. DOI: 10.3928/24748307-20190225-01. PMID: 31294310.
Article
24. Fatmawati A, Suhartanti I, Rahmawati DE. The relationship between health literacy and breastfeeding patterns in postpartum mothers. Amerta Nutr. 2023; 7(1 Suppl):12–16. https://doi.org/10.20473/amnt.v7i1SP.2023.12-16. DOI: 10.20473/amnt.v7i1SP.2023.12-16.
Article
25. Seçer I. Psychological test development and adaptation process: SPSS and LISREL applications [Psikolojik test geliştirme ve uyarlama süreci: SPSS ve LISREL uygulamaları]. Ankara, Publisher: Anı yayıncılık;2020.
26. Lewis TF. Evidence regarding the internal structure: confirmatory factor analysis. Meas Eval Couns Dev. 2017; 50(4):239–247. https://doi.org/10.1080/07481756.2017.1336929. DOI: 10.1080/07481756.2017.1336929.
Article
27. Boston University School of Public Health. PH717 Module 9. Correlation and regression: evaluating association between two continuous variables [Internet]. Boston (MA): Boston University School of Public Health;2016. [cited 2024 Nov 15]. Available from: https://sphweb.bumc.bu.edu/otlt/MPH-Modules/PH717-QuantCore/PH717-Module9-Correlation-Regression/.
28. Karakoç FY, Dönmez L. Basic principles of scale development. Tıp Eğitimi Dünyası. 2014; 40(4):39–49. https://doi.org/10.25282/ted.228738. DOI: 10.25282/ted.228738.
Article
29. Abay H, Alagöz F, Tekin ÖM. The Turkish validity and reliability of the maternal health literacy inventory in pregnancy. Midwifery. 2023; 125:103774. https://doi.org/10.1016/j.midw.2023.103774. DOI: 10.1016/j.midw.2023.103774. PMID: 37490808.
Article
30. Turkish Statistical Institute. Women in statistics, 2023 [İstatistiklerle Kadın, 2023] [Internet]. Ankara: Author; 2023 [cited 2024 Jun 11]. Available from: https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Kadin-2023-53675.
Full Text Links
  • WHN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2025 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr