Construct Validity of Health Literacy Scales and Causal Model of Sufficient Health among NCDs Risk Adults

Abstract

Background: Over 75% of Thai people’s deaths are caused by non-communicable diseases (NCDs), which is higher than all deaths worldwide at 71%. Objective: To develop a health literacy (HL) and sufficient health behavior (SHB) scale and examine the causal relationship model of SHB. Materials and Methods: The present study was a cross-sectional exploratory study among adults aged 20 to 60 at NCD risks. Six hundred thirty-six participants were sampled through stratified random sampling. The participants consisted of employees in public and private organizations and local people in urban and semi-urban communities. The research was done between August 2021 and March 2022. Confirmatory Factor analysis (CFA), and structural equation modeling (SEM) were used to analyze the data. Results: 1) In respect of construct validity, the 28-item HL Scale achieved an overall Cronbach’s alpha of 0.94 and a factor loading ranging between 0.67 to 0.84. Similarly, the 30-item SHB Scale achieved an overall Cronbach’s alpha of 0.94 and a factor loading ranging between 0.40 to 0.82. 2) The causal relationship model of SHB was consistent with the empirical data. In addition, HL positively influenced SHB (direct effect=0.82, p<0.001), and HL was a key factor that could predict SHB by 67.00%. Conclusion: Both developed scales are high-quality assessment instruments that can be used by healthcare providers in assessing NCD risks and predicting SHB to organize activities enhancing people’s HL and knowledge for decreasing NCD risk behaviors. © 2022 JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND.