JMIR Publications

ABSTRACT

Background:

Research on health literacy among migrant workers in Korea has been limited, especially given the lack of validated instruments and the lack of focus on the diversity of cultural backgrounds among migrant workers.

Objective:

This study aimed to develop and validate a health literacy scale for unskilled migrant workers (HLS-MW) in Korea.

Methods:

We first generated a pool of potential items based on a literature review and in-depth interviews with 23 migrant workers. Next, we reviewed empirical referents from the first step to select relevant medical terminologies and passages and chose 709 words. The study team initially generated 35 items with 709 health-related terms through empirical referent reviews. After content validity testing by an expert panel, 28 items comprising 89 terms on two subscales were selected for psychometric testing—prose and document. Overall, 402 unskilled migrant workers in South Korea completed a web-based survey, with 344 responses included in the final analysis. We used multiple analytic approaches, including exploratory factor analysis (EFA), Rasch analysis (item response theory), and descriptive analysis, to examine the validity and reliability of the new scale.

Results:

The final sample primarily included young male workers from South Asian countries. The HLS-MW yielded two factors. The item difficulty scores ranged from -1.36 to 2.56. The scale was reduced to 13 items (10 prose and 3 document items). The final version exhibited good internal reliability (Kuder-Richardson index=.88) and test-retest reliability (r=.74). HLS-MW scores differed significantly by Korean language proficiency (F=3.54, p=.004).

Conclusions:

The HLS-MW is a reliable and valid measure to assess health literacy among migrant workers in Korea. Further studies are needed to test the psychometric properties of the HLS-M in diverse migrant groups in Korea while also establishing cutoffs to help identify those in need of health literacy support.