Development and validation of a short form of the medication literacy scale for Chinese College Students

Chen ZhenzhenCollege of Science, Minzu University of China, Beijing, ChinaSchool of Nursing, China Medical University, Shenyang, Liaoning Province, China, Ren JiabaoCollege of Science, Minzu University of China, Beijing, ChinaSchool of Nursing, China Medical University, Shenyang, Liaoning Province, China, Duan TingyuHebei Institute of Communications, Hebei, China, Chen KeDepartment of Social Science and Humanities, Harbin Medical University, Harbin, Heilongjiang Province, China, Hou RuyiSchool of Journalism and Communication, Renmin University of China, Beijing, China, Li YimiaoSchool of Journalism and Communication, Renmin University of China, Beijing, China, Zeng LeixiaoSchool of Journalism and Communication, Renmin University of China, Beijing, China, Meng XiaoxuanTianjin Medical University, Tianjin, China, Wu YiboSchool of Public Health, Peking University, Beijing, China, Liu YuSchool of Nursing, China Medical University, Shenyang, Liaoning Province, China
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Abstract

Medication literacy is integral to health literacy, pivotal for medication safety and adherence. It denotes an individual's capacity to discern, comprehend, and convey medication-related information. Existing scales, however, are time-consuming and predominantly cater to patients and community dwellers, necessitating a more succinct instrument. This study presents the development of a brief Medication Literacy Scale (MLS-14) utilizing classical test theory (CTT) and item response theory (IRT), targeting a college student demographic. The MLS-14's abbreviated version, a 6-item scale (MLS-SF), was distilled through CTT and IRT methodologies, engaging 2431 Chinese college students to scrutinize its psychometric properties. The MLS-SF demonstrated a Cronbach's {\alpha} of 0.765, with three extracted factors via exploratory factor analysis, accounting for 66% of the cumulative variance. All items exhibited factor loadings above 0.5. The scale's three-factor structure was substantiated through confirmatory factor analysis with satisfactory fit indices (chi2/df=5.11, RMSEA=0.063, GFI=0.990, AGFI=0.966, NFI=0.984, IFI=0.987, CFI=0.987). IRT modeling confirmed reasonable discrimination and location parameters for all items, free of differential item functioning (DIF) by gender. Except for items 4 and 10, the remaining items were informative at medium theta levels, indicating their utility in assessing medication literacy efficiently. The developed 6-item Medication Literacy Short Form (MLS-SF) proves to be a reliable and valid instrument for the expedited evaluation of college students' medication literacy, offering a valuable addition to the arsenal of health literacy assessment tools.
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中国大学生用药知识简表的开发与验证
用药素养是健康素养的组成部分,对用药安全和坚持用药至关重要。它表示个人辨别、理解和传递与用药相关信息的能力。然而,现有的量表耗时较长,而且主要针对病人和社区居民,因此需要一种更简洁的工具。本研究利用经典测验理论(CTT)和项目反应理论(IRT),针对大学生群体开发了简明用药知识量表(MLS-14)。通过CTT和IRT方法对MLS-14的简缩版本--6个项目的量表(MLS-SF)进行了提炼,并让2431名中国大学生参与其中,以检验其心理测量学特性。MLS-SF的克朗巴赫系数(Cronbach's {alpha})为0.765,通过探索性因子分析提取了三个因子,占累积方差的66%。所有项目的因子载荷都在 0.5 以上。量表的三因素结构通过确认性因素分析得到证实,拟合指数令人满意(chi2/df=5.11,RMSEA=0.063,GFI=0.990,AGFI=0.966,NFI=0.984,IFI=0.987,CFI=0.987)。IRT 模型证实了所有项目都有合理的区分度和定位参数,不存在性别差异项目功能(DIF)。除第 4 项和第 10 项外,其余项目的信息量均在中等θ水平,表明其在有效评估用药知识方面的实用性。事实证明,所开发的6个项目的用药知识简表(MLS-SF)是一种可靠有效的工具,可用于快速评估大学生的用药知识,为健康素养评估工具系列提供了有价值的补充。
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