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August 27, 2026Evaluation & the Health ProfessionsOpen Access

Score Standardization of the European Health Literacy Survey Questionnaire Short Form (HLS-EU-Q16) in a Sample of Brazilian Adults

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Authors

FMFábio Luíz MialheUniversidade Estadual de Campinas (UNICAMP)FRFlávio RebustiniUniversidade de São Paulo

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Implication

Psychometric study demonstrates dichotomous scoring improves health literacy categorization in adults, indicating local score standardization prevents costly clinical misclassifications.

Key Points

  • Assess normative score data and validity of classification criteria for the Brazilian adaptation of the European Health Literacy Survey Questionnaire Short Form (HLS-EU-Q16).
  • Administered the HLS-EU-Q16 to N=783 adults (mean age 38.6 years) in Brazil.
  • Evaluated score categorization standards using discriminant analysis and decision tree algorithms.
  • A dichotomous classification scheme (low vs. high health literacy) yielded superior discriminant validity over the original three-level classification system.
  • Standardizing cutoff scores to regional population norms optimized classification accuracy, minimizing erroneous health literacy stratification.

Cite This Study

Mialhe et al. (2026) studied this question.

synapsesocial.com/papers/6a8fea3310c91c1e92622469https://doi.org/10.1177/01632787261479346
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Also Consider

Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Health literacy development is central to the prevention and control of non-communicable diseases2022 · 109 citations
  2. 2Measuring Health Literacy in Romania: Validation of the HLS-EU-Q16 Survey Questionnaire2022 · 50 citations