The Development of Health Literacy Tool for Behavior of Tuberculosis Prevention In Population Aged 15 years at Health Region 7

Abstract

This study was aimed to develop the health literacy Assessment tool for behavior of Tuberculosis prevention in population aged 15 years at health region 7. The initial step was to situation analysis through literature review based on the Nutbeam’s concept compose of 6 components i.e.cognitive, access, communication skill, self-management, media-literacy and decision skill. The preliminary tool was undergone content analysis by six experts. Next step, the preliminary tool was undergone content analysis by six experts to select the items with the index of item-objective congruence (IOC). Pilot study the health literacy assessment tools was obtained with sample groups of 60 persons at Maha sarakham municipality, for validation of the tests is to approve its reliability and discrimination. The final the health literacy assessment tools were obtained with sample groups of 240 persons in area Kalasin municipality and Roi Et municipality. Validation of the tests is to approve its construct validity and cut score. Data of Analyses were the confirmatory factor analysis and content analysis.  The results revealed that   

 1) The content validity was determined by 6 experts yielding IOC over ≥0.5; item of IOC rang 0.33 to 1.00 and total of tools was 0.68. The preliminary assessment tool was obtained with 39 items.

          2) The proposed tool was validated in Maha sarakham municipality area and the Cronbach’s alpha was 0.93 or ranged from 0.76 to 0.85, the discrimination power ranging from 0.32 to 0.63, the Kuder-Richardson formula 20 score (KR-20) was 0.70, the difficulty score ranged from 0.40 to 0.90 and the final assessment tool was obtained with 34 items.

          3) The confirmatory factor analysis that the structural model was fit to the empirical data with goodness of fit statistic:  =11.175, df= 8, p-value = 0.1920 ( = 1.3968) RMSE = 0.005, SRMR =0.021, CFI =0.994, TLI = 0.989 as the illustrations show. It was also found that the weights of influence were 3 components: access explained (b= 8.26, = 0.484)  self-management (b= 9.556, = 0.683), communication skill (b = 8.26, R² = 0.529), decision skill (b = 6.802, R² = 0.529), media-literacy (b= 4.565, R² = 0.438) and cognitive (b = 1.000, R² = 0.090).

4) The cut-off score of criterion-referenced grading by Bloom was 120-150 points were high health literacy and under 120 points were low health literacy