Osman, Abdi D ORCID: https://orcid.org/0000-0002-8104-8019, Kruger, Gina ORCID: https://orcid.org/0000-0003-2291-7648, Yasan, Caglayan ORCID: https://orcid.org/0000-0002-5002-7637, Philip, Jalaja S ORCID: https://orcid.org/0000-0002-2309-5458 and Bhowmik, J ORCID: https://orcid.org/0000-0001-9697-1968 (2026) Validation of the HLS-EU-Q16 Questionnaire for a Regional Setting. Advances in Public Health, 2026 (1). ISSN 2356-6868

Abstract

Objective: This study aimed to validate the HLS-EU-Q16 questionnaire for the Victorian (Australia) adults following the COVID-19 pandemic by using a cross-sectional survey. Methods: A single-arm cross-sectional study guided by the STROBE checklist was conducted on 774 individuals from the Victorian population during the 2023 academic year, utilising the HLS-EU-Q16 questionnaire along with additional socio-demographic questions. Principal component analysis and factor analysis were used to analyse the data. Results: The two-factor solution from the exploratory factor analysis accounted for 45.2% of the total variance in the HLS-EU-Q16. The findings support the factorial structure and reliability of the 16-item health literacy scale, with Cronbach’s alpha values of 0.86 for Factor 1 and 0.85 for Factor 2, demonstrating excellent internal consistency. The results from the confirmatory factor analysis suggest the model demonstrates acceptable to good fit, with fit indices as follows: CFI = 0.947, NFI = 0.925, RMSEA = 0.060 and SRMR = 0.07. Conclusion: The study findings suggest that the HLS-EU-Q16 is psychometrically robust and suitable for assessing and measuring HL for the Victorian adult population with two factors. The identified factors can be utilised in future research to better understand the HL status of the population through two distinct dimensions.

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