Spanish version of the short European Health Literacy Survey Questionnaire HLS-Q12: Transcultural adaptation and psychometric properties

Sergio Muñoz-Villaverde; Leticia Serrano-Oviedo; María Martínez-García; Yolanda Pardo; Llüisa Tares-Montserrat; Francisco Javier Gómez-Romero; Paloma Garcimartin

doi:10.1371/journal.pone.0299736

Peer Review History

Original SubmissionDecember 27, 2022
29 Nov 2023 Decision Letter - I Gede Nyoman Mindra Jaya, Editor PONE-D-22-34462Spanish version of the short European Health Literacy Survey Questionnaire HLS-Q12: transcultural adaptation and psychometric propertiesPLOS ONE Dear Dr. Muñoz-Villaverde, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Jan 13 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. 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Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The paper is well written. Nevertheless, here are my concern to improve the paper. 1. Since the authors had already used CFA, I suggest the authors to replace the reliability analysis by the one based on CFA. The authors may refer to Hair et al. (2014; p. 619) for construct reliability and Bollen (1989; p. 221) for item reliability. In Tabel 6: 2. The column “Predictor” may be deleted. 3. I suggest to change “Standardised latent variable” to “standardised loading factor” and “Standardised variances” to “Standardised error variances”. In Table 9: 4. the title “Estimators”, change to “Estimates”. 5. Please clarify the statistical test relating to the “p-value”! Reviewer #2: The article highlights and justifies the need to adapt and validate the questionnaire European Health Literacy Survey Questionnaire HLSQ12 to Spanish. One of the possible important biases is the lack of sample, but the authors correctly justify the limitations and propose how to correct it in future research. In the description of the groups, although it is specified in Table 3, it would provide the most relevant data in the text with the total samples, as it has done with one of the subsamples. The bibliographic references are well-structured, relevant and up-to-date. Regarding the form, with reference to the final questionnaire and Table 1, homogenize the use of capital letters in all questions. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0299736.r001
Revision 1
27 Dec 2023 Author Response Response to reviewers and editor Thank you for your kind contributions. We have introduced changes based on the suggestions that will contribute to enrich our manuscript. The following is a point-by-point reply to each of the considerations that we received. Editor- When submitting your revision, we need you to address these additional requirements. Thank you for reminding us to double check PLOS ONE´s style requirements. We have done this and have addressed accordingly as follows. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf andhttps://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf After a meticulously read, we have followed PLOS ONE´s style requirements and highlighted accordingly throughout the text, so changes can be reflected. We hope that no requirements have been missed. 2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. In methods and in the ethics approval and consent to participate sections, the word written has been added in lines 96, 240 to informed consent to state the type of consent that was obtained. 3. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. The reference list has been checked and ensure that to our knowledge it is correct. Dois have been added to some of the references, these have been highlighted in the reference section within the manuscript. Reviewer #1. Reviewer 1 stated: The paper is well written. Nevertheless, here are my concern to improve the paper. Thank you so much for your feedback and appreciation. About the concerns to improve the paper: Comment #1. Since the authors had already used CFA, I suggest the authors to replace the reliability analysis by the one based on CFA. The authors may refer to Hair et al. (2014; p. 619) for construct reliability and Bollen (1989; p. 221) for item reliability. Thank you for your advice and for sharing those references, to keep up to date with new recommendations for internal consistency measuring we have considered your references incorporating McDonald´s omega (construct reliability/composite reliability) calculated through SEM. However, we have considered to leave alpha´s value as it is the traditional of way reporting reliability and yet is still considered a valid measurement of reliability. Hope this is not a problem. We have incorporated up-to-date references accordingly lines 588,591. We have also introduced lines 56, 200, 310, 397 in abstract, methods, results and in discussion to incorporate McDonald´s omega. In Table 6: Comment #2. The column “Predictor” may be deleted. Comment #3. I suggest to change “Standardised latent variable” to “standardised loading factor” and “Standardised variances” to “Standardised error variances”. Thank you for these suggestions. As per your recommendation this column has been deleted as it does not add any extra value to the table. And in the manuscript in line 320 it is already stated that HLS-Q12 is a one-dimensional model. Also, we have taken into account your suggestion a have renamed Standardised latent variable” to “Standardised loading factor” and “Standardised variances” to “Standardised error variances” in table 6 in line 324. In Table 9: Comment #4. the title “Estimators”, change to “Estimates”. As recommended Estimators have been changed to Estimates in table 9 in line 367. In table 9: Comment #5. Please clarify the statistical test relating to the “p-value”! Thank you for indicating clarification for the statistical test use relating the p-value. Due to normality of the variables, t-test was used for calculation of p-values in the total sample and subsamples. The following comment has been added to the table on the calculation of p-values for a better understanding in lines 372,373: * The p-values correspond to the result of the t-test (parametric) calculation after checking normality of the comparing mean changes of pre-post intervention in HLS-Q12 scores. Reviewer #2. Reviewer 2 stated: Comment #1. The article highlights and justifies the need to adapt and validate the questionnaire European Health Literacy Survey Questionnaire HLSQ12 to Spanish. One of the possible important biases is the lack of sample, but the authors correctly justify the limitations and propose how to correct it in future research. Thank you for comment. As you have correctly highlighted, this has been accordingly justified in the limitation’s sections, however the fact that this questionnaire has been validated in an oncology population brings an important value to the scientific community, as this may be considered a strength in the absence of previous studies of the HLS project in cancer patients in Spain. Comment #2. In the description of the groups, although it is specified in Table 3, it would provide the most relevant data in the text with the total samples, as it has done with one of the subsamples. Thank you so much for your input regarding the description of the groups. In the text before the table that describes the total sample and subsamples, the following information has been added in lines 276-279 to expand the information regarding the samples: “describes the characteristics of the total sample consisting of 60 patients and the two subsamples that were used for the analysis of sensitivity to change, 47 stable patients (78.3%) which ECOG was 0 or experienced an improvement in ECOG, from 1 to 0, and 13 non-stable (21.7%) or worsening patients, who did not show clinical improvement”. Comment #3. The bibliographic references are well-structured, relevant and up-to-date. This is appreciated, thank you so much for your input. However, some updates have been made to references as a couple of references needed to be incorporated for a better justification. These have been highlighted in the reference section within the manuscript. Also, Dois have been incorporated into the references. Comment #4. Regarding the form, with reference to the final questionnaire and Table 1, homogenize the use of capital letters in all questions. Thank you for your comment, however we have wanted to follow the same structure of the original questionnaire, and hence the questions are kept in low cases. In addition, in S1 Appendix (final questionnaire), capital letter F has been added for grade number 3. Fácil, as in the previous appendix this was in low cases. After a complete and a thorough review of the manuscript, and adding to the comments from the reviewers, we the authors have found out a transcription error in the theoretical range of the PELC questionnaire, which is 47-235 and not 63-219 as stated in the manuscript. We do apologize for this data error and have updated through the text in line 149. And in table 3, line 294-295. Also, maximum likelihood estimation in line 193 in the original manuscript was deleted, as the model that we considered for construct validity and CFA was the the weighted least squares means and variance adjusted (WLSMV) model as it was already stated in lines 193-194 in the original manuscript and in line 207 in the revised manuscript. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0299736.r002
16 Feb 2024 Decision Letter - I Gede Nyoman Mindra Jaya, Editor Spanish version of the short European Health Literacy Survey Questionnaire HLS-Q12: transcultural adaptation and psychometric properties PONE-D-22-34462R1 Dear Dr. Muñoz-Villaverde, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, I Gede Nyoman Mindra Jaya Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0299736.r003
Formally Accepted
19 Feb 2024 Acceptance Letter - I Gede Nyoman Mindra Jaya, Editor PONE-D-22-34462R1 PLOS ONE Dear Dr. Muñoz-Villaverde, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. I Gede Nyoman Mindra Jaya Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0299736.r004

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