Validation of the Death Literacy Index in a Representative UK Sample

Background/aims: A key construct within the public health approach to palliative care is ‘death literacy’. Death literacy can be defined as ‘the knowledge and skills that people need to make it possible to gain access to, understand, and make informed choices about end of life and death care options’. The newly developed 29-item Death Literacy Index (DLI; Leonard et al, 2020) can be used to determine levels of death literacy across multiple contexts, including at a community/national level, and to evaluate the outcome of different public health interventions. The DLI is the first rigorously developed measure of the construct of death literacy, which is a key outcome for new public health approaches to palliative care (a priority public health area). The current study aims to provide the first validation of the DLI in a representative UK population sample.

Methods: A large nationally representative sample of 399 participants, stratified by age, gender and ethnicity, was prospectively recruited via an online crowdsourcing platform. The factor structure of the DLI was investigated using CFA. Internal consistency of subscales were assessed, alongside construct validity.

Results: Tests of dimensionality confirmed the original measure structure with substitution of one item. The subscales possess good internal consistency. Construct validity is currently being assessed to include convergent, divergent and known-group validity and will be presented.

Conclusions: The 29-item DLI will have application in evaluating new public health approaches to palliative care across the UK. This will help in addressing the dearth of formally evaluated interventions in this area, and potentially help inform service development.