Development and implementation of Taiwan's Child Health Literacy Test

Chieh Hsing Liu, Li Ling Liao*, Shu Fang Shih, Tzu Chau Chang, Hsueh Yun Chi, Richard H. Osborne

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Objectives: The aims of this study were to develop Taiwan's Child Health Literacy Test and to undertake a nation-wide survey in order to determine the current status of Taiwanese sixth graders' health literacy, and to understand the association between health literacy, healthy behavior, and health status. absp Methods: Taiwan's Child Health Literacy Test was developed through the process of concept clarification, a qualitative pilot, a development pilot, and a field test. In the field test, 162,609 sixth graders (56.9%) from 2,235 schools (83.3%) nationwide completed the questionnaire. We also collected the students' dates of birth, BMIs, self-reported health and healthy behaviors. absp Results: The final test consisted of 32 questions with item discrimination of 0.55-1.89 and item difficulty of-1.7-0.41 according to IRT; Cronbach's a was 0.87. Based on this information, the test was deemed appropriate for basic health literacy screening among children. Nation-wide, the average score for sixth graders' health literacy was 23.97 points (total score 32 points), with a correct rate of 74.9%. Those who were "good" in self-reported health scored highest in health literacy (M = 24.29). Health literacy was significantly positively related to healthy behavior (r = .25, p< .05), and negatively to risky behavior (r =-.28, p< .05). absp Conclusions: This study was the first curriculum-based child health literacy test developed from the viewpoints of both teachers and pupils in Taiwan through a rigorous procedure. The nationwide survey results may serve as a reference for decision-makers at the national health education level.

Original languageEnglish
Pages (from-to)251-270
Number of pages20
JournalTaiwan Journal of Public Health
Issue number3
Publication statusPublished - 2014 Jun 1


  • Curriculum-based
  • Health literacy
  • Student children

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Development and implementation of Taiwan's Child Health Literacy Test'. Together they form a unique fingerprint.

Cite this