Development and psychometric assessment of a health literacy-based questionnaire to differentiate between office workers with and without non-specific neck pain

Background: Health literacy is an individual’s ability to seek, understand, and utilize health information. High health literacy leads to positive health behaviors and better health outcomes. Objective: The primary aim of the present study was to identify domains of health literacy that was able to differentiate between office workers with and without non-specific neck pain, and the results were used to develop a questionnaire. The secondary aim was to determine the discriminative validity, internal consistency, and test-retest reliability of the questionnaire. Materials and Methods: Three professors, 10 physical therapists, and 20 office workers took part in in-depth interviews. Data from 280 office workers with neck pain and 195 without neck pain were used for factor analysis and psychometric property assessment, respectively. Results: Domains of health literacy relating to non-specific neck pain included accessing, understanding, appraising, applying, and extrinsic/intrinsic factors. Only the applying domain, i.e., the working and exercise behaviors of office workers, was able to differentiate between office workers with and without neck pain. The questionnaire was then developed and contained six questions. The score ranged from 0 to 24 and the higher the score indicates better health behaviors. Mann-Whitney U test showed that the total score of the developed questionnaire was significantly lower in office workers with neck pain than in those without neck pain (p<0.05), indicating acceptable discriminative validity. Conclusion: The questionnaire based on health literacy concept was developed. The questionnaire had good discriminative validity, internal consistency, and test-retest reliability. The questionnaire is a promising tool for identifying office workers at risk for the development of non-specific neck pain.