Development of the Older Adults Health Literacy Index


  • Thanida Pumthait Suan Dusit University
  • Doungnetre Thummakul Suan Dusit University
  • Yadarat Baljay Navamindradhiraj University


health literacy, older adults


Introduction: In an assessment of health literacy among older adults,   using an appropriately developed health literacy index will provide basic and important information for healthcare of older adults. As a result, this will lessen older adults’ dependence on health service system. There will be a benefit for managing the influence of risk factors among older adults’ health.  That would be a guideline to increase health literacy among older adults.

      Objective: To develop health literacy index of older adults residing in Bang Phlat district, Bangkok.

      Research methodology: This mixed-method study employed both qualitative and quantitative approaches. Qualitative participants were 11 voluntary healthcare volunteers who were older adults residing in Bangphlat district. Quantitative participants were older adults residing in Bangphlat district.  Simple random sampling technique was used to randomly select 6 out of 48 communities.  Then, 396 participants were recruited using an accidental sampling method. Instruments were a semi-structured interview guide, and a health literacy questionnaire   consisting of 40 indicators. An item-objective congruence was verified by 3 experts. Reliability was tested using a Cronbach’s alpha coefficient (0.96). Qualitative data were analyzed using content analysis and analytical induction. Older adult’s health literacy index development data were analyzed using exploratory factor analysis, and confirmatory factor analysis. LISREL was also used to verify data.

      Results: Exploratory factor analysis result showed that 4 questions were ineffective in measuring health literacy. Health literacy index measurement model was congruent with empirical data (c2(358, N=393) = 402, p= .051, AGFI = 0.90) and ratio between c2 and degree of freedom = 1.12.  All factor loadings were statistically significantly positive values (0.54 to 0.82) (p< .01). Those 8 factors were as follows:  1) health literacy accessibility; 2) media literacy; 3) self-management; 4) communication skill; 5) healthcare accessibility; 6) literacy; 7) understanding of health information; and 8) understanding of healthcare (ordered from highest to lowest factor loading). Hence, this measurement for older adults’ health literacy index is applicable.

Conclusion: The measurement of health literacy of the elderly is suitable for use. This can be used to assess the level of health literacy of the elderly to suit their age.

Implications: Health care teams can use this measurement to assess the health literacy of the elderly in the community. For the benefit of development health literacy of the elderly and development to still in changing situations from the risk of intellectual inertia resulting from deterioration systems.


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How to Cite

Pumthait T, Thummakul D, Baljay Y. Development of the Older Adults Health Literacy Index. JHNR [Internet]. 2021 Nov. 29 [cited 2023 Jan. 31];37(3):192-204. Available from:



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