Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Psychological and Social Foundations

Major Professor

Kathy Bradley-Klug, Ph.D.

Committee Member

Robert Dedrick, Ph.D.

Committee Member

Emily Shaffer-Hudkins, Ph.D.

Committee Member

Audra Walsh, Ph.D.


Health literacy, youth, chronic conditions, self-advocacy, resiliency, validity


Chronic health conditions in youth have increased over the last several decades. It is estimated that within the United States there are between 15% to 18% of youth who are living with a chronic health condition (Centers for Disease Control and Prevention [CDC], 2010). The CDC defines a chronic health condition as an illness that lasts for three months or longer that can be managed, but not cured (CDC, 2010). Although there is some research on youth living with chronic illnesses, there are minimal studies that assess the constructs of health literacy, resiliency, and support/advocacy within this population. The current investigation was a validity study of the Health Literacy and Resiliency Scale (HLRS). This is a newly developed 37-item measure that assesses the level of health literacy, resiliency, and support/self-advocacy among chronically ill youth (Bradley-Klug, Shaffer-Hudkins, Lynn, DeLoatche, & Montgomery, 2017). Specifically, the study correlated the construct of resiliency in the HLRS with the resiliency construct from the Child Youth and Resiliency Measure (CYRM; Ungar & Liebenberg, 2011). This measure is a 28-item measure that assesses levels of resiliency among youth and young adults. The goals for this study included: 1) determining the extent to which the results of the factor analysis from the current study are consistent with the three-factor model from the original study, 2) assessing the relationship between the HLRS and the CYRM, and 3) determining the reliability (internal consistency) of the scores of the HLRS. More importantly, since there have only been preliminary analyses conducted on the psychometric properties for the HLRS, this study was the first step towards providing validation for this measure. Participants were recruited through several methods including community-based organizations and online outlets. There were a total of 226 participants, with 54% identifying as White, 31% African American, and the remaining identifying as other. Sixty-one percent were female. The participants were English-speaking with a diagnosis of a chronic health condition given at least six months prior. Some of the conditions that were frequently identified among the sample included: diabetes, HIV, lupus, cystic fibrosis, ADHD, and asthma. Individuals were asked to complete the HLRS, CYRM, and a demographic survey online. The results indicated that the reliability of the values of the three factors in the HLRS ranged from acceptable to excellent. The results also included a correlation between the scores from the HLRS and CYRM. For the HLRS there were strong correlations between the resiliency and support/self-advocacy factors and health literacy and support/self-advocacy factors. For the CYRM, there was a strong correlation (r =.954) with the resiliency factor indicating that the resiliency factor within the HLRS aligns with the resiliency construct that is measured in the CYRM. Some items on the HLRS loaded on more than one factor indicating the need for further consideration of particular items on that scale. Overall, these data provide additional support for the HLRS scale and suggest that the scale may be a step closer to being utilized in applied settings.

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