The development and application of the ABCDE-health literacy scale for Thais

Abstract

Background: The 7th Global Conference on Health Promotion was held in 2009. The World Health Organization advocated focus on the development of health literacy (HL), which refers to cognitive and social skills of individuals to access, understand, and use information to promote and maintain a healthy life. Objectives: To synthesize and develop an ABCDE (alcohol, baccy, coping, diet, and exercise) HL Scale for Thai adults, to evaluate their HL, and to determine whether the path model of HL influences health outcomes. Methods: The synthesis used 12 research articles published in PubMed and Science Direct (1996-2013), and the participants used to test the research hypothesis were Thais aged >15 years. We selected 4,401 participants by systematic sampling, who responded to a 5-point scale for 64 items, with a Cronbach-coefficient of reliability between 0.61 and 0.91. Results: (1) The HL scales were in a good range of factor loading from 0.326 to 0.861. (2) The overall HL of the subjects was fair for 72.0%. The health outcomes were poor for 53.5% of all participants, fair in 44.7%, and good in 1.8% percent. (3) The path model of HL that influences health outcomes was consistent with the empirical data (χ2 27.48, with 7 degrees of freedom, P = 0.003, and root mean square error of approximation of 0.032). Conclusions: We recommend application of the ABCDE-HL Scale for Thai Adults as a screening tool to develop HL using a public health promotion policy for Thai adults with low levels of HL.