The psychometric testing of the functional, communicative, and critical health literacy tool

Carli A. Zegers, Kelly Gonzales, Lynette M. Smith, Carol H. Pullen, Armando De Alba, Kathryn Fiandt

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objective: The purpose of this study is to assess the validity and reliability of the English version of the FCCHL tool in urban and rural, socioeconomically vulnerable or unstable, chronic comorbid adults in the United States. Methods: A cross-sectional study measuring both validity and reliability. Results: A total of 276 participants were recruited. Internal consistency was measured using Cronbach's alpha of α = 0.87. External reliability was measured by test-retest methodology. Construct validity was measured using Confirmatory Factor Analysis that showed good fit. Criterion validity was measured by comparing the mean scores of the FCCHL tool sub-scales. Concurrent validity was measured by comparison of means of the FCCHL tool and education level compared to the NVS and s-TOFHLA. Conclusion: The results demonstrated that the FCCHL tools is measuring three different concepts. Overall, the FCCHL tool was seen to have good validity and reliability in the identified population. Practice Implications: The FCCHL tool is a 14-item, self-report health literacy tool measuring more than functional health literacy. The tool can be used in practice to improve not only functional health literacy, but also communicative and critical which is highly applicable.

Original languageEnglish (US)
Pages (from-to)2347-2352
Number of pages6
JournalPatient Education and Counseling
Issue number11
StatePublished - Nov 2020


  • Communicative health literacy
  • Critical health literacy
  • Health literacy
  • Tool psychometrics

ASJC Scopus subject areas

  • General Medicine


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