General health literacy scale for Thais and comparison between age groups

BACKGROUND: Health literacy (HL) has captured the world's interest since it was first defined by WHO in 1998. In Thailand, a number of HL scales for risk groups have been developed but none for the general population. Therefore, this research aimed to develop a general health literacy (GHL) scale for Thais and compare HL levels between groups, i.e. students, youth, adults, and older. METHODS: In this mixed-methods study, a focus group was conducted with 20 health policy-makers. Data were collected from 4,000 participants from all regions of Thailand through questionnaires between 2018 and 2019. The participants were divided into 4 age groups: aged 7–14, 15–24, 25–59, and 60–75. All of them were selected using stratified random sampling. Data analysis was performed using CFA and ANOVA. RESULTS: 1) The GHL Scale for Thais comprised 47 items, covering 5 domains i.e. access to health information and services, understanding of health information and service leading to practice, health information and service appraisal, communication and social support, and health self-management. The scale had high Cronbach's alpha values for all participants and different age groups (Cronbach's alpha = 0.95–0.97) and factor loadings ranging from 0.45 to 0.77. 2) Most Thai people (58.9%) had a fair level of HL, followed by high HL (24.3%) and low HL (16.8%). 3) The comparison of HL among age groups had different mean scores (P < .05) and low HL was found in adults (25.00%), older (18.60%), youth (12.60%), and students (11.40%), respectively. CONCLUSION: The GHL Scale for Thais can be used to screen people of all ages for potential health problems and develop strategies for promoting health resilience and preventing disease in each age group.