A p value of 0.05 determined the significance. Multivariate analysis was also done using multiple logistic regression to determine factors associated with limited health literacy controlled for confounding effects. Factors associated with 'limited' health literacy was determined by using univariate analysis and assessing their associations using chi square test. Based on a score, respondents were divided into four levels of health literacy as 'inadequate', 'problematic', 'sufficient' and 'excellent' as well as into two levels as 'limited' and 'adequate'. Health literacy assessment was based on self-reported competencies to access, understand, judge and apply health information in the domains of disease prevention, healthcare and health promotion. This study aimed to describe the level of health literacy and the factors associated with it among school teachers in an Education Zone in Colombo, Sri Lanka.Ī cross-sectional study among 520 teachers measured health literacy using the selfadministered, culturally adapted Sinhalese translation of Health Literacy Survey-European Union (HLS-EU). Health literacy refers to people's competencies to access, understand, judge and apply health information in healthcare, disease prevention and health promotion. Future studies should be conducted in order to confirm and expand our findings. Our study provides valuable novel evidence on concurrent validation of two major HL instruments in a South Eastern European population-based sample. For both instruments, higher HL scores were significantly associated with younger age, higher educational and economic level and lower body mass index. Mean values of both instruments were similar in men and women (mean score for TOFHLA: 76.0 vs. Both tools exhibited a high stability over time (Spearman's rho: 0.88 for TOFHLA and 0.87 for HLS-EU). The internal consistency was high for both instruments (Cronbach's alpha for the test procedure was 0.92 for TOFHLA and 0.98 for HLS-EU-Q). A structured interviewer-administered questionnaire was applied twice (test and retest procedure after 2 weeks) including HLS-EU-Q and TOFHLA instruments. The aim of this study was to assess the concurrent validity of the European Health Literacy Survey Questionnaire (HLS-EU-Q) and the Test of Functional Health Literacy in Adults (TOFHLA) in a population-based sample of adults in Albania.Ī cross-sectional study was conducted in 2013 in Tirana, Albania, including 239 individuals aged ≥ 18 years (61% women 87% response). There are no HL reports from Albania to date. Health literacy (HL) is an under-explored topic in South Eastern European countries. Public health practice has come to increasing recognition of health promotion and the central role of knowledge, attitude, beliefs and practices in achieving health promotion.