The development of health literacy assessment tool for sexually transmitted infection (STI) prevention among vocational school students

Abstract

This study aimed to develop a health literacy assessment tool for sexually transmitted infection (STI) prevention in vocational students in the Health Region 7 of Thailand. The initial step was to select assessment topics through literature review based on the Nutbeam’s concept. The preliminary tool was comprised of 65 assessment items for male and 60 items for female, which was undergone content analysis by five experts to select the items with the index of item-objective congruence (IOC) over ≥0.5. As a result, the final assessment tool was obtained with 53 items for male and 52 items for female. The proposed tool was validated among sample groups of 100 males and 100 females, and the discrimination power ranging from 0.2-0.8 was observed. In addition, the difficulty score ranged from 0.4-0.9, the Kuder–Richardson Formula 20 score (KR-20) ranged from 0.4-0.6, and Cronbach’s alpha ranged from 0.6 to 0.9. The assessment tool was subsequently utilized in two sample groups of 100 males and 100 females. The confirmatory factor analysis showed that the model was consistent with empirical data with the goodness of fit statistics (for the male tool: 2 = 13.038, df= 6, p=0.161, 2/df = 2.173, RMSE = 0.067, SRMR =0.043, CFI =0.977, TLI = 0.962; and for the female tool: 2 = 10.907, df = 9, p=0.282, 2/df = 1.211, RMSE = 0.046, SRMR = 0.046, CFI = 0.978, TLI = 0.963). The main weights of influence for health literacy included three components: access to information and services, communications skill, and self-management. The cut-off score was 77 points for male and 82 points for female. In conclusion, the assessment tool was found to be useful; and it should be widely used for measuring health literacy in other vocational students.