Psychometric analysis of an organizational health literacy questionnaire for schools

Introduction

Establishing the health literate school framework (HeLit-Schools) represents a key public health goal. By implementing a whole-of-school organizational development approach, HeLit-Schools aims at supporting students health literacy and their academic development. However, research on HeLit-Schools remains scarce with only limited tools and interventions available. This study uses Rasch analysis to validate the psychometric properties of the “organizational health literacy in schools questionnaire” (OHLS-Q), which is based on the HeLit-Schools.

Methods

The OHLS-Q was evaluated in a sample of school management board members (N = 604) from five different federal states in Germany, using WINSTEPS software. Data were collected via a 20-minute online survey between 12/2022-07/2023. All eight subscales were analyzed separately, each covering one standard of the HeLit-Schools. Each subscale comprises six items which can be rated on a 4-point Likert scale. Using Rasch analysis, the categorical responses of the eight subscales were converted into linear measures. Unidimensionality, item fit statistics, and further validity indices to assess the quality of the measurement tool were computed.

Results

Unidimensionality could be confirmed and the rating scale worked as intended for all eight subscales. Item fit could be confirmed for five subscales. The other three subscales revealed one misfitting item each. All eight subscales showed acceptable person reliability (0.71-0.80) and person separation index (1.53-2.02). Item reliability (0.97-1.00) and item separation (5.00-20.74) were excellent.

Discussion

The OHLS-Q proved to be a reliable measurement tool. The misfitting items in three of the eight subscales need to be further investigated. The measurement tool will be one of the first validated tools for assessing organizational health literacy in schools, providing significant value for implementing and achieving public health goals for children and adolescents.

Key messages

• The “organizational health literacy in schools questionnaire” (OHLS-Q) is a novel measurement tool to assess the implementation of the health literate school framework.

• Psychometric properties of the OHLS-Q were validated using Rasch analysis, proving the tool to be reliable. Further investigation needs to explore the misfitting items in three of the eight subscales.