The progression on the measurement instruments of maternal health literacy: A scoping review

Maternal health literacy is essential for high-quality maternal and child health. However, there is no consensus on the selection and application of maternal health literacy measurement instruments. Thus the aim of this scoping review is to provide an overview of existing literature on application characteristics, appraisal content, and psychometric properties of maternal health literacy measurement instruments.A scoping review followed the Arksey and O'Malley's methodology and reported results by using PRISMA-ScR. A literature search was conducted of 12 databases on articles published between database creation and July 27, 2021, involving pregnant and postpartum women (over the age of 18). Eligible articles underwent full-text review and data extraction to summarize the application characteristics, appraisal content, and psychometric properties of instruments.Thirty-nine articles were included and twenty instruments were identified. The most widely used instruments were objective instruments, represented by the Newest Vital Sign; subjective instruments were represented by the Single Item Literacy Screener; comprehensive instruments were represented by "the health literacy scale for perinatal pregnant women" (Chinese). All instruments measured "personal skills", but less attention was paid to "psychological factors" and "health-related activities". Only a few articles reported the psychometric properties of the instruments, and the instruments were evaluated for reliability using Classical Test Theory.Scientific and reliable maternal health literacy measurement instruments can greatly advance high-quality maternal and child health. The future research direction of instruments should construct rapid maternal health literacy measurement instruments; the appraisal content needs to be enriched in multiple dimensions and introduce more scientific and reliable psychometric methods to verify the reliability of instruments.