Development And Validation Of The Conversational Health Literacy Assessment Tool (CHAT)



Introduction/Background: Health literacy provides a useful framework to assess health equity issues for individuals. The need for a multidimensional health literacy tool for use in time-limited healthcare settings prompted the development of a structured assessment tool that supports clinicians to engage clients in conversation about health literacy. The nine domains of the Health Literacy Questionnaire (HLQ) provided the conceptual foundation for the development of the Conversational Health Literacy Tool (CHAT). The CHAT is intended for use in brief clinical interactions by clinicians in various settings and for a range of engagement points (e.g., intake, review or discharge assessments). Method: CHAT item development included e-consultation and a workshop with clinicians. Next, clinicians from different health professions pilot tested the draft tool with clients and participated in cognitive interviews. A second round of interviews elicited further clinician feedback and recommendations. Results: The CHAT was administered for validation by 18 clinicians from 6 health professions. Interview data (n=13) indicated that the CHAT supported authentic conversations with clients about health literacy, was particularly useful for new clients, and would support new or student healthcare professionals to identify client health literacy needs. Data also indicated the potential for different clinical professions to use CHAT data for different purposes. Conclusions: The CHAT demonstrates early promise as a practical health literacy assessment tool to identify and develop appropriate responses for individual clients in clinical settings. Further research is needed to clarify how different health professions might interpret and use CHAT data. Keywords: Equity in health Health promotion Health systems Research methodologies and methods Key Messages 1. The need for a structured health literacy tool for brief clinical interactions prompted the development of the Conversational Health Literacy Assessment Tool (CHAT). 2. The CHAT validation indicates it is a useful and appropriate health literacy assessment tool for clinical settings. 3. Interpretation and use of CHAT responses by clinicians of different professions is the subject of ongoing research.


Melanie Hawkins

Deakin University

Melanie Hawkins is a part-time researcher and part-time PhD scholar in the Health Services Improvement Unit (HSIU) at Deakin University in Melbourne, Australia. Her research interests are in health program evaluation, qualitative research methods, health literacy, patient and clinician perspectives, questionnaire development, and validation of the interpretation and use of questionnaire outcomes.