Croatian Translation and Linguistic Adaptation of the Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50)

Abstract

Introduction: Population needs health literacy (HL) in order to understand health-related topics. Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50) could be a high-quality tool for assessing HL in adults. Unlike questionnaires in the English language, which are not easily modifiable for Croatian, translation of SAHLSA-50 from Spanish into Croatian could be an appropriate choice. There are no similar questionnaires to assess HL in Croatian to date.
Aim: To translate SAHLSA-50 into Croatian using a validated procedure and to adapt it linguistically, so that it could be used in the Croatian-speaking area to measure HL in the Croatian population.
Material and Methods: SAHLSA was developed for the Spanish-speaking population by Lee et al. It consists of 50 items and is based on multiple choice questions. A score between 0 and 37 suggests that the respondent has inadequate HL. After the protocolized translation process (translation/back-translation), the final version of the Croatian translation of SAHLSA-50 was produced, after we introduced several changes that do not represent a direct translation of the Spanish items. Most of the changes were made because of a cultural difference in common use or in the meaning of the term.
Conclusion: SAHLSA-50 was translated and adapted into Croatian using the standard translation/back-translation procedure. The Croatian version will now be available as an important part of epidemiological and clinical studies, as a useful tool for evaluating the levels of HL in the Croatian-speaking population. Validation of the translated Croatian version in practice would be the next step.