Objectives: This study aimed to develop and validate the reproductive health literacy questionnaire for Chinese unmarried youth aged 15-24.
Methods: We conducted a validity and reliability study of the questionnaire through a cross-sectional survey and test-retest analysis in four districts in Shanghai between April and June 2017. A total of 1587 participants completed a self-administered questionnaire anonymously on-site and the trained investigators conducted quality check afterwards. Sixty participants among them completed the test-retest assessment with 2 weeks interval. The reliability was determined by internal consistency, spilt-half reliability and test-retest reliability. The construct validity was assessed by confirmatory factor analysis.
Results: The 58-question reproductive health literacy questionnaire for Chinese unmarried youth demonstrated high internal consistency (Cronbach's α = 0.919), spilt-half reliability (Guttman splitting coefficient = 0.846) and test-retest reliability (correlation coefficient = 0.720). The confirmatory factor analysis showed that the construct of the questionnaire fitted well with the hypothetical model. The reproductive health literacy scores in unmarried girls aged 15-24 were higher than boys (P < 0.05) and college students who lived in rural areas when they were middle and high school obtained lower score than those living in cities and suburbs (P < 0.01).
Conclusion: The reproductive health literacy questionnaire for Chinese unmarried youth demonstrated good reliability and validity, which could potentially be used as an effective evaluation instrument to assess reproductive health literacy among Chinese young people.
Keywords: Questionnaire development; Reproductive health literacy; Unmarried youth; Validation.
Despite growing research into evaluation structures for adolescent health literacy in the general population, there is currently a research scarcity in health literacy assessment tools for youth sexual and reproductive health. This is the first time the WHO health literacy framework has been used to construct and evaluate reproductive health literacy among Chinese youth. In this study, we described the questionnaire’s development process, reliability and validity, and utilisation among 1587 unmarried youth in Shanghai, China. Our findings indicated that the 58-item questionnaire we developed is effective to assess the reproductive health literacy in Chinese unmarried youth aged 15–24, which includes four aspects of literacy ability (accessing, understanding, appraising, and applying) to three health domains (reproductive health determinants, behavioural risk factors, and health service utilisation). The development of this tool can not only measure the reproductive health literacy level, but also be used for long-term monitoring, as well as facilitating effect evaluation of intervention. This questionnaire may also help to develop target interventions to improve reproductive health literacy of Chinese young people.
© 2021. The Author(s).