5 Citations (Scopus)


Objective: We aimed to develop a health literacy battery for three phases of stroke (HL-3S). Methods: Three Rasch-based item banks corresponding to health care, disability prevention, and health promotion in the acute, subacute, and chronic phases of stroke, respectively, were developed by a multidisciplinary stroke team. To construct the HL-3S, a panel of clinical and Rasch experts selected items from the three Rasch-based item banks according to content representativeness and item difficulty diversity. Additionally, the validity and reliability of the HL-3S were examined using Rasch analysis. Results: This study included 442 patients. Each of the three tests in the HL-3S contained 10 items with a 5-point scale of difficulty levels. The items in HL-3S demonstrated unidimensionality, local independence, and favorable Rasch reliability. Conclusion: The HL-3S, with 10 items in each test, had favorable construct validity and Rasch reliability. The HL-3S can be considered as a quick-to-administer and phase-adaptive test battery of health literacy for stroke survivors. Practice Implications: Clinicians may select one of the tests in the HL-3S corresponding with the patient's stroke recovery timeline and thereby provide adaptive health education programs to increase the patient's ability to actively participate in health care, disability prevention, and health promotion, respectively.

Original languageEnglish
Pages (from-to)2342-2346
Number of pages5
JournalPatient Education and Counseling
Issue number11
Publication statusPublished - Nov 2020


  • Health literacy
  • Outcome assessment
  • Phases of stroke recovery
  • Rasch analysis
  • Stroke

ASJC Scopus subject areas

  • General Medicine


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