Health Literacy Scale and Causal Model of Childhood Overweight

Background: WHO focuses on developing health literacy (HL) referring to cognitive and social skills. Our objectives were to develop a scale for evaluating the HL level of Thai childhood overweight, and develop a path model of health behavior (HB) for preventing obesity . Study design: A cross-sectional study. Methods: This research used a mixed method. Overall, 2,000 school students were aged 9 to 14 yr collected by stratified random sampling from all parts of Thailand in 2014. Data were analyzed by CFA, LISREL . Results: Reliability of HL and HB scale ranged 0.62 to 0.82 and factor loading ranged 0.33 to 0.80, the subjects had low level of HL (60.0%) and fair level of HB (58.4%), and the path model of HB, could be influenced by HL from three paths. Path 1 started from the health knowledge and understanding that directly influenced the eating behavior (effect sized - β was 0.13, P<0.05. Path 2 the health knowledge and understanding that influenced managing their health conditions, media literacy, and making appropriate health-related decision β=0.07, 0.98, and 0.05, respectively. Path 3 the accessing the information and services that influenced communicating for added skills, media literacy, and making appropriate health-related decision β=0.63, 0.93, 0.98, and 0.05. Finally, basic level of HL measured from health knowledge and understanding and accessing the information and services that influenced HB through interactive, and critical level β= 0.76, 0.97, and 0.55, respectively. Conclusions: HL Scale for Thai childhood overweight should be implemented as a screening tool developing HL by the public policy for health promotion