Reliability and validity of the musculoskeletal health literacy questionnaire (MSHLQ) among community-dwelling rural elderly: a pilot study Doi: https://doi.org/10.55522/jhpo.V3I4.0097

Abstract

Musculoskeletal disorders are a leading cause of disability among community-dwelling elderly, and health literacy specific to musculoskeletal health strongly influences self-management and treatment-seeking behaviour. Condition-specific instruments to assess musculoskeletal health literacy in rural elderly populations are limited. This pilot study evaluated the reliability and validity of a newly developed Musculoskeletal Health Literacy Questionnaire (MSHLQ). Methods: A cross-sectional pilot study was conducted among 50 community-dwelling elderly (age ≥60 years) in rural Ahilyanagar, Maharashtra, India. The self-developed 16-item MSHLQ comprises four domains — Accessing, Understanding, Appraising, and Applying information — each scored from four items on a 4-point Likert scale (0-3). Internal consistency was assessed using Cronbach's alpha, corrected item-total correlations, split-half (Spearman-Brown) reliability, and a one-way random-effects Intraclass Correlation Coefficient (ICC). Construct validity was examined through domain-total score correlations and inter-domain correlations using Pearson's coefficient. Results: The mean total MSHLQ score was 19.88 ± 11.08 (range 5-42). Overall Cronbach's alpha was 0.892. Corrected domain-total correlations ranged from 0.622 to 0.836, and all domains correlated significantly with the total score (r = 0.753-0.918, p<0.001). Split-half reliability (Spearman-Brown corrected) was 0.908, and average-measures ICC was 0.758 (95% CI 0.628-0.852, p<0.001). Based on total scores, 58% of participants demonstrated inadequate, 22% problematic, and 20% adequate musculoskeletal health literacy. Conclusions: The MSHLQ demonstrates good internal consistency and construct validity in this pilot sample of rural elderly, supporting its potential utility as a domain-specific instrument for assessing musculoskeletal health literacy. Further validation with item-level test-retest reliability and larger, more diverse samples is recommended before wider clinical application.  outcomes.