Development of the Older Adults Health Literacy Index
Keywords: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.
Kaeodumkoeng K, Thummakul D. Health literacy promoting in aging population. Journal of Health Science Research 2015;9(2):1-8. (in Thai)
Institute for Population and Social Research, Mahidol University. Thai population in the reign of King Rama IX. Nakhon Pathom: Institute for Population and Social Research, Mahidol University; 2017. (in Thai)
Palumbo R. Sustainability of well-being through literacy, the effects of food literacy on sustainability of well-being. Agriculture and Agricultural Science Procedia 2016; 8: 99 -106.
Kimberly AK, Melody SG, William DM, Christopher RC, Richard TG. Effect of cognitive dysfunction on the relationship between age and health literacy. Patient Education and Counseling 2014; 95: 218–25.
Knodel J, Teerawichitchainan B, Prachuabmoh V, Pothisiri W. The situation of Thailand’s older population: an update based on the 2014 survey of older persons in Thailand. Chiang Mai: HelpAge International; 2015.
Nutbeam D. Defining and measuring health literacy: what can we learn from literacy studies?. Int J Public Health 2008;54:303–5.
Haun JN, Valerio MA, McCormack LA, Sørensen K, Paasche-Orlow MK. Health literacy measurement: an inventory and descriptive summary of 51 instruments J Health Commun 2014; 19, Suppl 2:302-33. doi: 10.1080/10810730.2014.936571. PMID: 25315600.
Nguyen HT, Kirk JK, Arcury TA, Ip EH, Grzywacz JG, Saldana SJ, et al. Cognitive function is a risk for health literacy in older adults with diabetes. Diabetes Research and Clinical Practice 2013;101: 141-7.
Public Health and Environmental Strategy Division. Bangkok elderly data report from the population base in the civil registration system as of December 2018. Bangkok: Strategy and Evaluation Department. 2019 (in Thai)
Rajah R, Hassali MAA, Murugiah MK. A systematic review of the prevalence of limited health literacy in Southeast Asian countries. Public Health 2019;167:8-15.
Chunga MH, Chen LK, Peng LN, Chi MJ. Development and validation of the health literacy assessment tool for older people in Taiwan: Potential impacts of cultural differences. Archives of Gerontology and Geriatrics 2015;61:289-95.
Lee TW, Kang SJ, Lee HJ, Hyun SI. Testing health literacy skills in older Korean adults. Patient Education and Counseling 2009;75:302-7.
Chinn D, McCarthy C. All Aspects of Health Literacy Scale (AAHLS): Developing a tool to measure functional, communicative, and critical health literacy in primary healthcare settings. Patient Education and Counseling 2013;90: 247-53.
Intarakamhang U. Health Literacy: measurement and development. Bangkok: Behavioral Science Research Institute, Srinakharinwirot University; 2017. (in Thai)
Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 3rd edition. Thousand Oaks, California: SAGE; 2018.
Yamane T. Statistics: An Introductory Analysis. 3rd edition. New York: Harper and Row Publications; 1973.
Kanchanawasee S. Traditional Theory of Testing. 7th edition. Bangkok: Chulalongkorn University Press; 2013. (in Thai)
Best JW, Kahn JV. Research in Education. 10th edition. New Delhi: Prentice-Hall of India Publications; 2006.
Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 8th edition. Harlow: Pearson Education Limited; 2014.
Ganguli M, Hughes TF, Jia Y, Lingler J, Jacobsen E, Chang CH. Aging and Functional Health Literacy: A Population-based Study. Am J Geriatr Psychiatry 2020; Article in Press.
Manca S, Bocconi S, Gleason B. “Think globally, act locally”: A glocal approach to the development of social media literacy. Computers & Education 2021;160, 104025.
Taylor JL, Roberts L, Hladek MD, Liu M, Nkimbeng M, Boyd CM, Szanton SL. Achieving self-management goals among low income older adults with functional limitations. Geriatric Nursing 2019;40(4):424-30.
Bambini V, Tonini E, Ceccato I, Lecce S, Marocchini E, Cavallini E. How to improve social communication in aging: pragmatic and cognitive interventions. Brain and Language 2020;211, 104864.
Perlman C, Kirkham J, Velkers C, Leung RH, Whitehead M, Seitz D. Access to psychiatrist services for older adults in long-term care: a population-based study. Journal of the American Medical Directors Association 2019;20(5):610-6.e2.
Oliveira D, Bosco A, Lorito C. Is poor health literacy a risk factor for dementia in older adults? Systematic literature review of prospective cohort studies. Maturitas 2019;124:8-14.
Chang SJ, Yang E, Lee KE, Ryu H. Internet health information education for older adults: A pilot study. Geriatric Nursing 2021;42(2):533-9.
Fernandes JM, Araújo JF, Vieira JM, Pinheiro AC, Vicente AA. Tackling older adults’ malnutrition through the development of tailored food products. Trends in Food Science & Technology 2021; 115:55-73.
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