中文多面向健康識能量表（MMHLQ）之發展

Development of Mandarin Multidimensional Health Literacy Questionnaire (MMHLQ)

目標：本研究目的在發展一個適用於台灣成人的中文多面向健康識能量表。方法：首先經焦點團體訪談、專家內容效度、語文適讀修正等程序發展檢測題目；接著以566名成人為測定樣本，用以檢測量表心理計量特質及檢定測量模型適配度；最後以2,394名成人為效化樣本，用以檢測量表複核效度。結果：結果顯示二階五因素的測量模型適配度良好。量表包含五個面向：「獲取健康資訊」、「理解健康資訊」、「評估健康資訊」、「應用健康資訊」及「溝通與互動」，共20題自陳式題目。心理計量分析顯示量表的內部一致性信度、再測信度、建構效度、聚斂效度、區辨效度、效標關聯效度及已知群組效度表現良好。複核效度檢定結果，符合跨樣本的量尺不變性。最後，以標準參照方式訂出健康識能程度分級的切分點。結論：MMHLQ為具有良好信、效度的多面向健康識能測量工具，可用以評量群體的健康識能程度，也可做為教育介入的需求評估工具。

Objectives: The objective of this study was to develop a tool capable of measuring multidimensional health literacy among adults in Taiwan. Methods: In the first phrase, we adopted focus-group interviews, consultations with experts, and readability check to formulate calibration items. In the second phrase, a calibration sample of 566 adults was recruited to examine the psychometric characteristics of the items and test the fitness of the measurement model. In the last phrase, a validation sample of 2394 adults was used for evaluating cross-validation. Results: CFA demonstrated the high degree of fitness of the proposed second-order five-factor model. The proposed scale covers the following five dimensions: accessing, understanding, appraising, and applying health information, and communication and interaction. The scale includes 20 selfreported items. Psychometric analysis demonstrated that the scale has high internal consistency and test-retest reliability as well as good construct, convergent, discriminant, criterion-related, and known group validity. Cross-validation analysis demonstrated the metric invariance of the scale across the two samples. Cutting scores were selected for criterion-referenced grading. Conclusions: Our findings indicate that the Mandarin Multidimensional Health Literacy Questionnaire (MMHLQ) is a reliable and valid measure of multi-dimensional health literacy. The tool is useful in evaluating the level of health literacy among adult populations as well as in needs assessments geared toward interventions to improve health literacy.