Validation of the High Blood Pressure Health Literacy Scale in Vietnamese-Americans

Monday, 30 July 2012: 11:00 AM

Tam H. Nguyen, RN, MSN/MPH
School of Nursing, The Johns Hopkins University, Baltimore, MD
Miyong T. Kim, PhD
Health Systems and Outcomes, Johns Hopkins University, Baltimore, MD


Purpose:  Despite the progress that has been made in improving cardiovascular health in the U.S. during the last decade, many minority populations still experience significant health disparity gaps that stem from both a paucity of valid research and a lack of culturally sensitive care. In particular, there has been concern about the growing prevalence of high blood pressure (HBP) among Vietnamese Americans.  Compounding that concern, many Vietnamese Americans suffer from insufficient health literacy (HL).  A major obstacle in implementing appropriate HBP interventions for this group is a lack of culturally appropriate HL assessment tools. Therefore, the purpose of this study is to validate the 43-item High Blood Pressure Health Literacy Scale (HBP-HLS) (Kim et al., 2011), in a sample of Vietnamese Americans  


To evaluate the internal consistency and reliability of the HBP-HLS, the KR-20 coefficient was calculated on a sample of 189 Vietnamese Americans with HBP and pre-HBP.  To assess convergent validity, HBP_HLS was correlated with theoretically driven variables such as education and HBP knowledge. Convergent validity of the HBP-HLS was tested through correlations with the revised Rapid Estimate of Adult Literacy in Medicine (REALM). Additionally, the content validity index (CVI) of each item on the scale was assessed on a subsample of 10 Vietnamese Americans to ensure cultural relevancy and face validity.


Psychometric testing indicated that the scale was reliable (Kuder–Richardson-20 coefficient= 0.98). The HBP-HLS also significantly correlated with education (r = 0.63, p < 0.05), HBP knowledge (r = 0.37, p < 0.05) and the revised REALM (r = 0.93, p < 0.05), supporting convergent and concurrent validity. The CVI on each of the 43 items was >0.80.


The HBP-HLS is a valid and reliable instrument for assessing HBP related HL among Vietnamese Americans.  Additional testing in other populations will improve the generalizability of this tool.