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- 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
- Dheeraj Sharma
- J Prev Med Public Health. 2026;59(2):194-203. Published online March 30, 2026
- DOI: https://doi.org/10.3961/jpmph.25.893
- 189 View
- 39 Download
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Abstract
Summary
PDF - Objectives
Health literacy (HL) is a key determinant of health behaviors and health outcomes. However, the lack of validated Hindi-language instruments limits its assessment in India. This study aimed to translate, culturally adapt, and psychometrically validate 3 internationally recognized tools—the Short Assessment of Health Literacy in English (SAHL-E), the All Aspects of Health Literacy Scale (AAHLS), and the European Health Literacy Survey Questionnaire (HLS-EU-Q47)—for Hindi-speaking adults in rural North India.
Methods
A community-based cross-sectional study enrolled 250 adults from 5 villages in Uttar Pradesh. Translation followed forward–backward procedures with expert review and pretesting. Psychometric evaluation included internal consistency (Cronbach α), test–retest reliability (intraclass correlation coefficients, ICC), construct validity (exploratory factor analysis), convergent and known-groups validity, and feasibility indicators (completion rates and interview duration).
Results
All instruments demonstrated strong psychometric performance. Cronbach α values were 0.84 (SAHL-E), 0.87 (AAHLS), and 0.93 (HLS-EU-Q47), and ICCs ranged from 0.86 to 0.94. Factor structures aligned with theoretical expectations. Convergent correlations ranged from 0.42 to 0.61 (p<0.001), and known-groups validity analyses showed significant differences according to education and occupation. Completion rates exceeded 98%, and the mean interview duration was approximately 32 minutes.
Conclusions
The Hindi-adapted SAHL-E, AAHLS, and HLS-EU-Q47 demonstrated strong reliability, validity, and feasibility for assessing HL among rural adults in India. -
SummaryKey Message
The Hindi versions of SAHL-E, AAHLS, and HLS-EU-Q47 showed acceptable reliability and construct validity among rural adults in North India. The instruments retained their expected factor structures and demonstrated moderate correlations with each other, indicating related but distinct dimensions of health literacy. These findings support their use for assessing health literacy in Hindi-speaking rural populations.- Psychometric Properties of the Areas of Worklife Survey in an Industrial Context in Thailand
- Jate Ratanachina, Inthuon Hongsiri, Watcharakorn Chuthong, Wiroj Jiamjarasrangsi
- J Prev Med Public Health. 2026;59(1):75-85. Published online October 16, 2025
- DOI: https://doi.org/10.3961/jpmph.25.569
- 65,535 View
- 183 Download
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Abstract
Summary
PDF
Supplementary Material - Objectives
The Areas of Worklife Survey (AWS) is widely used to assess organizational factors contributing to burnout. However, evidence regarding its construct and criterion validity has been reported primarily in human service settings. This study evaluated the construct validity of the AWS measurement model and the criterion validity of the AWS–burnout relationship among industrial workers in Thailand.
Methods
In this cross-sectional study, a Thai-language electronic questionnaire was administered to 446 industrial workers between June 2024 and August 2024. Of these, 390 participants (87.4%) completed both the AWS and the Maslach Burnout Inventory–General Survey. Data were analyzed using confirmatory factor analysis within a structural equation modeling framework.
Results
A modified 6-factor (chi-square/degree of freedom [χ²/df], comparative fit index [CFI], Tucker– Lewis index [TLI], root mean square error of approximation [RMSEA], and standardized root mean square residual [SRMR]) AWS model—excluding 5 items and allowing 2 correlated error terms—demonstrated satisfactory fit (χ²(213)=436.02, p<0.001; χ²/df=2.05; CFI=0.94; TLI=0.92; RMSEA=0.053; SRMR=0.053). Convergent validity (composite reliability=0.74–0.87; average variance extracted [AVE]=0.49–0.58) and discriminant validity were acceptable for most dimensions; however, the Fairness dimension (AVE=0.36) and the Reward–Fairness correlation remained problematic. The partial mediation model demonstrated acceptable criterion validity, with all mediation paths—except reward to values—reaching statistical significance.
Conclusions
The AWS is a valid measure for assessing factors contributing to burnout among Thai industrial workers. Nevertheless, further refinement is necessary to ensure strong dimension-specific validity with minimal modification. -
SummaryKey Message
• The Areas of Worklife Survey (AWS) demonstrated acceptable construct and criterion validity for assessing organizational risk factors related to burnout among Thai industrial workers after model refinement. • A modified 18-item, six-factor structure showed good model fit and meaningful associations with burnout dimensions, supporting the AWS as a useful tool beyond human service settings.- Psychometric Characteristics of the Fear of Cancer Recurrence Inventory-Severity Subscale Among Korean Cancer Survivors
- So-Young Park
- J Prev Med Public Health. 2024;57(4):319-326. Published online May 16, 2024
- DOI: https://doi.org/10.3961/jpmph.24.096
- 20,725 View
- 348 Download
- 1 Web of Science
- 2 Crossref
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Abstract
Summary
PDF
- Objectives
Despite the importance of choosing and using a valid assessment tool for fear of cancer recurrence (FCR) for early detection and interventions, the validity of the FCR inventory has yet to be thoroughly investigated in Korea. This study explored the psychometric properties of the Fear of Cancer Recurrence Inventory-Severity (FCRI-S) subscale and assessed its applicability to cancer survivors in Korea.
Methods
The survey involved 93 Korean individuals who had survived cancer. The reliability of the FCRI-S subscale was assessed using Cronbach’s α and composite reliability (CR). Confirmatory factor analysis (CFA), along with tests for discriminant and convergent validity, was conducted to evaluate the construct validity of the FCRI-S subscale.
Results
The FCRI-S subscale showed excellent internal consistency (Cronbach’s α=0.88; CR=0.89). CFA showed a good factor structure for the FCRI-S subscale, and the correlations of the FCRI-S subscale with FCR-related measures (r=0.69 to 0.80) and other psychosocial measures (r=-0.23 to 0.37) confirmed both the convergent and discriminant validity of the FCRI-S subscale.
Conclusions
This study confirmed the robust psychometric characteristics of the FCRI-S subscale among cancer survivors in Korea. The use of the FCRI-S subscale would be helpful for health professionals to rapidly screen FCR levels in clinical settings. -
SummaryKorean summary
암 재발 두려움은 암 생존자들이 흔히 호소하는 심리사회적 어려움 중의 하나이다. 한국 성인 암 생존자들을 대상으로 암 재발 두려움-심각성 하위척도의 심리계량적 속성을 평가한 결과, 해당 하위척도가 좋은 타당도와 신뢰도를 보인 것으로 나타났다. 본 연구 결과는 임상 현장에서 암 재발 두려움에 대한 조기 발견과 적극적인 개입의 중요성을 강조한다.Key Message
Fear of cancer recurrence (FCR) has emerged as a significant and common concern among cancer survivors. This study evaluated the psychometric properties of FCRI-S subscale among Korean adult cancer survivors and confirmed its good validity and reliability. Findings of this research emphasize the importance of early detection and active interventions for FCR in clinical settings. -
Citations
Citations to this article as recorded by
- Validation of the Czech version of the nine-item Fear of Cancer Recurrence Inventory in differentiated thyroid cancer survivors
Petra Nemcikova, Alena Javurkova, Jaroslava Raudenska, Samuel Srobar, Vladimir Musil, Sebastien Simard, Ludmila Brunerova
Endocrine.2026;[Epub] CrossRef - Fear of cancer recurrence in oncohematological patients: assessment instruments and evidence-based psychological interventions — a systematic review
Ana Sancho-Martínez, María Rueda-Extremera, Sergio Alejandre-Carmona, María Cantero-García
Frontiers in Psychology.2025;[Epub] CrossRef
- Validation of the Czech version of the nine-item Fear of Cancer Recurrence Inventory in differentiated thyroid cancer survivors
- Public Sector Workers’ Mental Health in Argentina: Comparative Psychometrics of the Perceived Stress Scale
- Agustín Ramiro Miranda, Ana Veronica Scotta, Ana Lucía Méndez, Silvana Valeria Serra, Elio Andrés Soria
- J Prev Med Public Health. 2020;53(6):429-438. Published online October 5, 2020
- DOI: https://doi.org/10.3961/jpmph.20.229
- 11,243 View
- 220 Download
- 17 Crossref
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Abstract
PDF
- Objectives
Given that Argentinian public-sector workers are highly exposed to stressful conditions, and that the psychometric properties of the widely used Perceived Stress Scale (PSS) should be evaluated in different settings, this work aimed to compare the psychometric properties of the Latin American Spanish PSS-10 and PSS-4 and to identify the optimal scale for stress assessment.
Methods
A sample of 535 participants was randomly divided into 2 groups to evaluate dimensionality by exploratory and confirmatory factor analyses. The reliability of both scales was also evaluated. Convergent validity was estimated using the Executive Complaints Questionnaire, the average variance extracted, and the composite reliability. Discriminant validity was based on the correlation with the Utrecht Work Engagement Scale and the phi-square correlation between the components.
Results
The factor analyses supported bidimensionality of the PSS-10 (stress and coping), which showed a better fit than the PSS-4. Moreover, the reliability of the PSS-10 was higher, whereas the PSS-4 did not achieve adequate values of internal consistency. The PSS-10 was also correlated significantly with all validation scales, and presented proper internal convergent and divergent validity.
Conclusions
The PSS-10 is a reliable and structurally valid instrument to measure perceived stress and coping in a Latin American Spanish-speaking population with high work demands, and the findings of this study expand our knowledge on the geographical and sociocultural applicability of the PSS. -
Summary
Citations
Citations to this article as recorded by- Construct Validity of the Perceived Stress Scale 4 in a Norwegian Adult ADHD Community Population
Henrik Pedersen, Tatiana Skliarova, Stian Lydersen, Hege Hafstad, Audun Havnen, Mariela Loreto Lara‐Cabrera
Scandinavian Journal of Psychology.2026; 67(1): 230. CrossRef - The Development and Impact of a College Peer-Based Outdoor Wellness Program
Drew Murphy, Kevin Delucio, Melissa H. D’Eloia, Lindsay Poynter
Ecopsychology.2026;[Epub] CrossRef - Two-years mothering into the pandemic: Impact of the three COVID-19 waves in the Argentinian postpartum women’s mental health
Agustín Ramiro Miranda, Ana Veronica Scotta, Mariela Valentina Cortez, Elio Andrés Soria, Pracheth Raghuveer
PLOS ONE.2025; 20(3): e0294220. CrossRef - Understanding work engagement in public administration: A comprehensive bibliometric and systematic review of the past decade
Iqbal Saffariz Santosa, Erwan Agus Purwanto, Sumaryono Sumaryono, Puguh Prasetya Utomo
Social Sciences & Humanities Open.2025; 11: 101479. CrossRef - Personal and Program Factors in Counselors‐in‐Training's Professional Identity Development
Byeolbee Um, Dan Li, Jennifer Niles
Counselor Education and Supervision.2025; 64(3): 300. CrossRef - Psychometric and structural properties of the four-item version of the Perceived Stress Scale: a replication study in 8727 school attendees
Romain Brisson
Cogent Psychology.2025;[Epub] CrossRef - Co-Development and Content Validity of an Instrument to Collect Integratively the Social Determinants of Health in Postpartum Lactating People
Paula Eugenia Barral, Agustín Ramiro Miranda, Elio Andrés Soria
World.2025; 6(3): 120. CrossRef - Perceived stress, negative life events, and adiposity among Puerto Rican young adults in the South Bronx, New York, and San Juan, Puerto Rico
Jorge A. Gonzalez-Mejia, Andrea A. López-Cepero, Natishkah Knox, Hector R. Bird, Glorisa J. Canino, Cristiane S. Duarte, Shakira F. Suglia
Journal of Health Psychology.2025;[Epub] CrossRef - Psychometric properties of the Perceived Stress Scale (PSS-10) in silica-exposed workers from diverse cultural and linguistic backgrounds
Fiona Hore-Lacy, StellaMay Gwini, Deborah C. Glass, Christina Dimitriadis, Javier Jimenez-Martin, Ryan F. Hoy, Malcolm R. Sim, Karen Walker-Bone, Jane Fisher
BMC Psychiatry.2024;[Epub] CrossRef - A prospective cohort study of persistent endocrine-disrupting chemicals and perceived stress
Samantha Schildroth, Amelia K Wesselink, Traci N Bethea, Birgit Claus Henn, Alexa Friedman, Victoria Fruh, Chad M Coleman, Sharonda M Lovett, Anissa I Vines, Andreas Sjodin, Julianne Cook Botelho, Antonia M Calafat, Ganesa Wegienka, Jennifer Weuve, Donna
American Journal of Epidemiology.2024; 193(12): 1729. CrossRef - Antecedents of Work Engagement in the Public Sector: A Systematic Literature Review
Norfadhillaton Zahari, Maniam Kaliannan
Review of Public Personnel Administration.2023; 43(3): 557. CrossRef - Reliability and validity of a widely-available AI tool for assessment of stress based on speech
Batul A. Yawer, Julie Liss, Visar Berisha
Scientific Reports.2023;[Epub] CrossRef - Insomnia is associated with worry, cognitive avoidance and low academic engagement in Argentinian university students during the COVID-19 social isolation
Ana Veronica Scotta, Mariela Valentina Cortez, Agustín Ramiro Miranda
Psychology, Health & Medicine.2022; 27(1): 199. CrossRef - COVID-19-related stress in postpartum women from Argentina during the second wave in 2021: Identification of impairing and protective factors
Agustín R. Miranda, Mariela V. Cortez, Ana V. Scotta, Elio A. Soria
Midwifery.2022; 108: 103290. CrossRef - Memory enhancement in Argentinian women during postpartum by the dietary intake of lignans and anthocyanins
Agustín R. Miranda, Mariela V. Cortez, Ana V. Scotta, Luisina Rivadero, Silvana V. Serra, Elio A. Soria
Nutrition Research.2021; 85: 1. CrossRef - Triggering of postpartum depression and insomnia with cognitive impairment in Argentinian women during the pandemic COVID-19 social isolation in relation to reproductive and health factors
Agustín Ramiro Miranda, Ana Veronica Scotta, Mariela Valentina Cortez, Elio Andrés Soria
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