[Development of a health literacy scale for women of reproductive age: an examination of reliability and validity in a study of female workers].

Objectives: This study aimed to develop a Health Literacy Scale for women of reproductive age by creating an original scale based on a concept analysis of health literacy.

Methods: A 30-item scale was created through an examination of their content validity and face validity based on attributes derived from concept analysis conducted in previous research. The main survey consisted of a self-administered questionnaire distributed to 1,030 female workers between the ages of 20 and 39 residing in the Kinki and Tokai regions of Japan. An additional survey was administered to 424 participants, from whom written informed consent was obtained. The reliability of the scale was examined using Cronbach's alpha and by assessing the significance of the correlation coefficient with the additional survey. Validity was examined through a comparison with the Japanese version of the Health Promoting Lifestyle Profile (JLV-HPLP II) and by examining correlations with subscale scores of the Social Skills Self-Rating Scale for adults as well as scale scores for cervical cancer screening behaviors.

Results: For the main survey, 632 out of 1,030 (61.4%) responded, of which 622 (98.4%) were valid responses. For the additional survey, 86 out of 424 (20.3%) responded, of which 86 (100%) were valid responses. The original 30 items were reduced to 21 across four factors through item and factor analysis using the principal extraction method and promax rotation. The coefficient of determination was 0.537. These four factors were labeled: "Women's choice for adopting health information and practice," "Self-care during menstruation," "Knowledge of the female body," and "Sexual discussion with partner." Cronbach's alpha for each factor ranged from 0.72 to 0.83, and the overall value was 0.88. For the additional survey, the correlation on the overall scale was significant (r=0.85, P<0.01). Moreover, the new scale was significantly correlated with the JLV-HPLP II and the Social Skills Self-Rating Scale for adults (ps<0.01). The correlation with scale scores for cervical cancer screening behaviors was highly significant among those who had been screened (P<0.001).

Conclusion: The reliability and validity of this particular Health Literacy Scale were largely confirmed. The significant relationship observed between cervical cancer screening behaviors and the various scale scores suggests the practical applicability of health literacy education aimed at the prevention, early detection, and treatment of female-specific diseases.