Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational study

Background Health Literacy (HL) is an effective determinant of health and health behaviors. The HL for School-Aged Children (HLSAC) scale has five components, and a 10-item was developed by Paakkari in the Finnish language to measure the HL levels of adolescents. However, its validity and reliability were not tested among adolescents in the Bengali language. This study aimed to determine the validity and reliability of HLSAC among adolescents of secondary school children in Bangladesh. Methods A cross-sectional study was conducted among secondary school children in two different schools in Bangladesh. The schools were purposively selected, one from a rural community and another from an urban area. The participants were students graded between 7 and 9 at the time of enrollment. The validity and reliability of the HLSAC scale were checked by confirmatory factor analysis, convergent validity, Cronbach’s alpha, and test-retest reliability. Results A total of 312 students (mean age 13.5 years) were enrolled. The reliability of the HLSAC scale showed that Cronbach’s alpha was 0.759. The confirmatory factor analysis model fit appears robust as the p -value was not significant (p = 0.137), χ ² /df 1.263, RMSEA 0.029 and CFI = 0.982. The test-retest reliability of this scale was 0.557 (moderate). For the convergent validity, the Bengali version of the HLSAC scale was positively correlated with the General Self-Efficacy and Perceived Knowledge scales (all, p  < 0.05). Conclusion Our study found that the HLSAC scale, Bengali version is valid and reliable for school-aged adolescents in Bangladesh. This research finding allows for a suitable HLSAC scale to measure the level of HL among adolescents in Bangladesh.