Kontakt X:X | DOI: 10.32725/kont.2026.019

Validation of the HLS-Child-Q15 questionnaire in Czech primary school childrenNursing - Original article

Sylva Bártlová ORCID...1, *, Iva Brabcová ORCID...1, Věra Hellerová ORCID...1, Milena Mágrová ORCID...1, Alena Machová ORCID...1, Olga Dvořáčková ORCID...2
1 University of South Bohemia in České Budějovice, Faculty of Health and Social Sciences, Institute of Nursing, Midwifery and Emergency Care, České Budějovice, Czech Republic
2 University of South Bohemia in České Budějovice, Faculty of Health and Social Sciences, Institute of Laboratory Diagnostics and Public Health, České Budějovice, Czech Republic

Aim: To evaluate the psychometric properties of the Czech version of the HLS-Child-Q15 questionnaire among children aged 9-10 years.

Design: Cross-sectional validation study.

Methods: The study included 1,333 fourth-grade pupils from three regions of the Czech Republic. The translation process followed forward-backward translation procedures with expert panel review and pilot testing. Internal consistency was assessed using Cronbach's alpha and split-half reliability. Construct validity was examined using exploratory factor analysis (principal axis factoring with Promax rotation). Criterion validity was evaluated through logistic regression analyses investigating associations between health literacy levels and vaccination-related attitudes, knowledge, and behaviours.

Results: The Czech HLS-Child-Q15 demonstrated good internal consistency (α = 0.80; 95% CI 0.774-0.823) and satisfactory split-half reliability (r = 0.79). Exploratory factor analysis supported a three-factor structure, accounting for 41% of the total variance. Higher health literacy levels were significantly associated with more favourable vaccination-related outcomes.

Conclusion: The Czech adaptation of the HLS-Child-Q15 is a reliable and valid instrument for assessing health literacy in children aged 9-10 years. It can be applied in research and school-based health promotion practice.

Keywords: Children; Health literacy; Prevention; Psychometrics; Public health; Questionnaire validation
Grants and funding:

This study was supported by the Ministry of Health of the Czech Republic in cooperation with the Czech Health Research Council (Project No. NW24-09-00302).

Conflicts of interest:

The authors have no conflict of interest to declare.

Received: February 20, 2026; Revised: March 9, 2026; Accepted: March 20, 2026; Prepublished online: March 31, 2026 

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