Development and validation of a functional health literacy instrument in the Philippines

Functional health literacy (FHL) involves skills in writing, reading, oral expression, comprehension, and numerical calculations to successfully function and complete health-related tasks. This study aimed to develop and validate an instrument for measuring FHL in the Philippines using a mixed-method design. FHL-5TEST is an instrument consisting of five questions developed in consultation with local experts, translated to major Philippine languages, and underwent translation analysis, pretesting, cultural adaptation, and validation. A cross-sectional study was conducted in a random sample of 15-70-year-old Filipino residents to validate the instrument. The FHL-5TEST demonstrated high internal consistency, with a Cronbach’s alpha of 0.7690. Across different cut-off values, the sensitivity and specificity of the instrument in detecting limited FHL ranged from 60.9% to 86.0% and from 61.6% to 97.2%, respectively. The study demonstrated that the FHL-5TEST is a valid and reliable instrument to measure functional health literacy in the Philippines.