The Program for Enhance Health Literacy of the Older People: A Mixed Method Study

Abstract

This mixed method research aimed to develop and assess the effectiveness of a program for enhancing the health literacy of older people. The research was conducted in 2 phases. Phase 1 was survey-based research with 352 participants aged 60 years and older who were recruited into the study using simple random sampling. The data were collected using the Health Education Division ‘s health literacy assessment form; the health behavior questionnaires to prevent non-communicable diseases, epidemic diseases, and elderly’s vital epidemic diseases; and the World Health Organization quality of life  assessment form.  To ensure their reliability, the Cronbach’s alpha coefficients of the research instruments were assessed and were .86, .80 and .89, respectively. The Phase 1 data was analyzed using descriptive statistics.  Phase 2 was action research involving 33 major key informants  consisting of elderly group members, elderly care takers, community leaders, public hospital health officers, and health volunteers working with the elderly. The KIs provided data related to the elderly’s health problems and co-developed the program through focus groups and interviews. Content analysis was used to analyze the qualitative data. The program was subsequently implemented with a group of 66 older people from three villages who were purposively sampled into the study and divided into experimental and control groups with 33 participants each. T-tests were used to analyze the data.

The results of Phase 1 of the study revealed that the elderly’s overall health literacy, their health behaviors for preventing diseases, and their quality of life were at the “fair”, “good”, and “moderate” levels, respectively. Phase 2 revealed the following three major findings.  First, most of the elderly had a chronic illness, lacked knowledge needed for self-health care-taking, and lacked sufficient health literacy to effectively access health information from online media. Secondly, the elderly‘s health literacy program development included 4 activities, specifically: (1) an educational training program via video (VDO) covering  health changes in the elderly, (2) group sharing sessions to promote the elderly’s ability to eat well; have good, healthy teeth; and prevent themselves from getting sick,            (3) an exercise training program to strengthen their physical and mental health, and (4) skill training elated to accessing online health information and media literacy. Lastly, after the program’s completion, the experimental group’s overall levels of health literacy and quality of life had improved to the “good” level and their overall health behaviors for preventing diseases had also increased to the “very good” level. Additionally, the mean scores for the health literacy, health behaviors for preventing diseases, and quality of life of the experimental group were statistically significantly higher than those of the control group at p <.05. Therefore, this study can provide fundamental information for further research into enhancing the quality of life related to health literacy among the elderly.