Short Assessment of Health Literacy in English, All Aspects of Health Literacy Scale, and European Health Literacy Survey Questionnaire

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Characteristics
Domains assessed: Organizational Health Literacy
Specific context: General Health Promotion, Health Literacy
Validation sample population age: Adults: 18 to 64 years, Older Adults: 65+ years
Modes of administration in validation study : Face-to-face
Assessment: Self-reported
Cost: Free

Psychometrics
Sample size in validation study: 250
Administration Time (minutes): 5 minutes
Language of validated version: Hindi

Main article reference

Sharma, D. (2026). Cross-cultural Adaptation and Psychometric Validation of 3 Health Literacy Instruments (SAHL-E, AAHLS, and HLS-EU-Q47) in Hindi Among Rural Adults in North India. Journal of Preventive Medicine & Public Health, 59, 194-203. https://doi.org/10.3961/jpmph.25.893

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Corresponding author
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Dheeraj Sharma
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Description

The study validates three tools for Hindi-speaking adults: SAHL-E (18 items) objectively assesses functional health literacy through word recognition and comprehension; AAHLS (14 items) evaluates self-reported functional, communicative, and critical literacy; HLS-EU-Q47 (47 items) comprehensively measures accessing, understanding, appraising, and applying health information.

Year Measure first Published: 2026

Additional Articles:

About This Measure
Categorical scoring: No
Reliability: Test-retest correlation: .91
Modern Approach for Tool Development: Yes

About the Validation of this Measure
Country where validated: India
Content validity: Translation followed forward-backward procedures. Blinded back-translations were assessed by a multidisciplinary expert panel for semantic, idiomatic, experiential, and conceptual equivalence. Pretesting was then conducted with 20 adults via cognitive interviews to evaluate clarity and cultural acceptability.
Criterion validity: Convergent validity was supported by moderate-to-strong positive correlations among total scores: SAHL-E with AAHLS (r=0.48), SAHL-E with HLS-EU-Q47 (r=0.42), and AAHLS with HLS-EU-Q47 (r=0.61); all p<0.001.
Reliability (Cronbach Alpha): 0.87
Additional Notes: This page covers the AAHLS in specific.
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