J Korean Acad Nurs.  2021 Dec;51(6):769-781. 10.4040/jkan.21108.

Validity and Reliability of the Korean Version of Assessment of Health Literacy in Breast and Cervical Cancer Screening

  • 1College of Nursing Science, Kyung Hee University, Seoul, Korea
  • 2Graduate School of Education, Kyung Hee University, Seoul, Korea
  • 3School of Nursing, Johns Hopkins University, Baltimore, MD, USA


Health literacy is a significant determinant of health and health behaviors such as cancer screening. Despite its significance, there are limited instruments available to assess health literacy targeting Koreans. The purpose of this study was to test the psychometric properties of Korean translation of a validated health literacy instrument in cancer screening—Korean version of assessment of health literacy in breast and cervical cancer screening (K-AHL-C).
A total of 555 women aged 20~65 participated in the online survey study. Of 52 items addressing five domains included in the original version, we focused on 36 items addressing three key domains closely associated with cancer screening: familiarity, health navigation, and comprehension.
During content validation, two items from the health navigation domain were removed, yielding 34 items. Using Rasch analysis and confirmatory factor analysis, we found the evidence of construct validity of K-AHL-C. The Korean version was also significantly correlated with measures of Functional Health Literacy scale, cancer prevention behaviors, and subjective health status, suggesting convergent validities respectively. Finally, K-AHL-C had acceptable reliability coefficients (α) ranging from 0.71 to 0.92 for each domain and the total scale.
These psychometric properties support the K-AHL-C is a valid and reliable instrument for measuring Koreans’ health literacy in cancer screening. Also it is expected to use the instrument to detect breast and cervical cancer early and improve the screening rate, and ultimately to contribute to the promotion of women's health and women's health nursing practice.


Health Literacy; Cancer Screening; Breast; Uterine Cervix; Psychometrics
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