Health Literacy and Role Performance of Prison Health Volunteers in Health Region 6

Abstract

            Health literacy plays a crucial role in enhancing the operational capabilities of inmates serving as Prison Health Volunteers (PHVs). This analytical cross-sectional study aimed to examine how personal factors and components of health literacy in health promotion and disease prevention could predict the role performance of PHVs in Health Region 6. A total of 332 inmates who served as PHVs were selected using simple random sampling from 10 correctional facilities within Health Region 6. Data were collected using a questionnaire measuring health literacy in health promotion and disease prevention, as well as the role performance of PHVs in Health Region 6. Instrument quality was evaluated through several measures. Content validity scores ranged from 0.6 to 1.0. The difficulty index of the health literacy questionnaire was within the acceptable range of 0.27 to 0.80. Discrimination indices ranged from 0.20 to 0.91. Reliability was assessed using KR-20 and Cronbach's alpha coefficients, which demonstrated acceptable internal consistency. The reliability coefficient for the first dimension of the health literacy questionnaire was 0.79, while other dimensions ranged from 0.86 to 0.95. Data were collected using a questionnaire developed by the researcher. Descriptive statistics and multiple regression analysis were employed to analyze the data, with a significance level set at .05.
            The study found that the majority of PHVs were male (90.66%), with a mean age of 35.9 years (SD = 7.91). The average duration of being a PHV was 18.5 months (SD = 10.94). Most participants demonstrated overall health literacy at a very good level (44.58%). Regarding their role performance, the majority were rated at a good level (33.73%), followed by a very good level (27.41%). Factors that significantly predict the role performance of PHVs included: (1) personal factor—duration of being a PHV (B = .099, 95% CI = .044 - .153); and (2) health literacy factors—access to health information and services (B = .344, 95% CI = .016 - .671), communication skills (B = .63, 95% CI = .188 - 1.072), self-management skills (B = .46, 95% CI = .072 - .848), and media literacy (B = .715, 95% CI = .365 - 1.065). These variables collectively explained 34.9% of the variance in PHVs’ performance. The study findings can inform the development of training programs aimed at strengthening the capacity of PHVs, particularly in improving access to health information and services, communication skills, self-management, and media literacy. Furthermore, encouraging experienced PHVs to serve as mentors for newer volunteers may enhance operational performance and contribute to more effective health promotion and disease prevention efforts within correctional settings.