Examining the Psychometric Properties of the Health Literacy Tool Related to Fatty Liver Among Women; [روانسنجی ابزار سنجش سواد سلامت مرتبط با کبد چرب در زنان ایرانی] Publisher



Vakilinejad S ; Rahmani A ; Taymoori P ; Fallahi A
Source: Iranian Journal of Health Education and Health Promotion Published:2026

Abstract

Background and Objective: Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver disorders and a leading cause of liver-related mortality, imposing a significant economic burden on society. This study aimed to design and psychometrically evaluate an instrument for assessing NAFLD-related health literacy in women. Material and Methods: This psychometric study was conducted in 2024 in Sanandaj. The initial items were developed based on literature review, existing questionnaires, and relevant documents, resulting in a 97-item preliminary version. Face and content validity were assessed by a panel of experts and through interviews with eligible women. After content validation, the number of items was reduced to 33. The questionnaire was then administered to 330 women aged 18–60 years. Finally, reliability and construct validity were evaluated. Results: The face and content validity assessment of the 33 items showed acceptable indices, including an item impact score of 1.5, a content validity ratio (CVR) of 0.62, and a content validity index (CVI) of 0.79. Exploratory factor analysis identified six factors—basic skills, decision-making, comprehension, knowledge, analysis, and behavior— with factor loadings greater than 0.4, explaining 61.35% of the total variance. Cronbach's alpha coefficients ranged from 0.71 to 0.90 for the subscales, and the overall reliability of the instrument was confirmed with an alpha of 0.94. Conclusion: The 33-item NAFLD health literacy questionnaire for Iranian women demonstrates satisfactory validity and reliability and is recommended for use in future studies to assess NAFLD-related health literacy. © 2025 Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy ofthis licence, visit https://creativecommons.org/licenses/by/4.0/.