Introduction

Health literacy undertakes a crucial role in patients’ abilities to cope with the disease and interact with healthcare systems. This becomes even more evident in high-burden diseases such as cancer where literacy plays a major role for patients who need to be empowered to make decisions based upon the available information with the necessary skills, confidence, and autonomy. So, measurement of cancer literacy is crucial to outline and implement adequate programs and strategies that positively impact patients’ cancer literacy.

In Portugal health literacy measurement is recent and there is an absence of validated tools that allow measuring literacy in specific disease contexts such as cancer. Considering the characteristics of the internationally available tools, we selected CHLT-30 to evaluate cancer literacy in Portuguese cancer patients, and this work describes its translation, cultural adaptation and validation for the Portuguese context.

Methods

A multidisciplinary team of health experts did the translation and cultural adaptation of the CHLT-30. A test-retest to validate the Portuguese version (CHLT-30 PT) was conducted in a population of cancer patients (n=51). Descriptive statistics were used to characterize the sample. Reliability (test-retest and internal consistency) and construct validity of CHLT-30 PT were assessed.

Results

The results obtained show a good and acceptable internal consistency of the tool, (Cronbach’s alpha=0.869 in the test and 0.771 in the retest). Patients' raw score mean (number of correct answers) in both test (23.57) and retest (25.95) and the distribution of scores categories are not statistically different, proving the validity of the questionnaire.

A suggestive association between higher education level and better scores was found, similar to the original report of CHLT-30-DKspa implementation. No statistically significant associations were found between score categories and gender, age, or type of health system.

Conclusion

This is the first adapted and validated tool to measure cancer literacy in the Portuguese population. The use of this tool in clinical practice will allow outlining patients’ cancer literacy along the cancer care continuum, enabling the identification and implementation of adequate socio-educational strategies with highly positive impacts on health outcomes.