The development and validation of Chinese Health Literacy Scale (CHLS) for older people

•Health literacy is an independent, direct, and decisive factor of self-report health.•The Chinese Health Literacy Scale (CHLS) is a validated tool for measuring health literacy level of the older adults in China.•The assessment of health literacy will play a guiding role in the formulation of policies and the provision of health services. We tried to develop a more concise health literacy scale for Chinese older adults. A draft scale based on the Health Literacy Questionnaire (HLQ) was developed, and revised by experts. We conducted a pilot study to test the readability and establish a standard inquiry method within 10 residents. We tested the validity and internal consistency using a field test with 3,739 participants. Overall standardized Cronbach's α of Chinese Health Literacy Scale (CHLS) was 0.86 and that of each dimension ranged from 0.69 to 0.81. Nearly all dimensions had satisfactory factor loadings (0.33-0.98). The correlation coefficient between the score of each item and its dimension ranged from 0.59 to 0.92. The performance of CHLS was almost the same as the HLQ but more concise. It might play a role in reflecting the health literacy of older adults in China and further promoting their health.