การพัฒนาเครื่องมือคัดกรองความแตกฉานด้านสุขภาพของชาวไทยที่อิงวิธีการของแบบวัด Newest Vital Sing

Abstract

The purpose of this study was to develop and test the Thai Health Literacy Assessment Instrument: (Nutrition label) or THLA-N and determine the cut-off score for interpreting the level of health literacy (HL). THLA-N was developed to assess HL by using the questions measuring the ability to use nutritional labels and reading ability. Five experts (researcher in scale development, physicians, pharmacists, nurses and public health officers) determined face validity of the scale. Subsequently the scale was tested to identify possible misunderstandings using think aloud technique in 15 subjects. The researcher then tested the revised measure in 30 subjects. The test of the THLA-N in 497 subjects revealed that the scale reliability was 0.72. The validity of the scale was evident because those with a higher level of education showed a higher level of THLA-N (P <0.001). Moreover, the THLA-N showed positive and statistically significant correlations with 2 indicators of HL i.e., understanding of health documents and reading ability as measured by the scale modified from S-TOFHLA. For ROC curve analysis, the THLA-N had an AUC of 0.76 (P <0.001) when using the sum of understanding of health documents and reading ability as measured by the scale modified from S-TOFHLA (GS1) as gold standard and 0.81 (P <0.001) when using understanding of health documents (GS2) as gold standard. Overall, the scale was able to discriminate those with adequate HL from those with inadequate HL. The THLA-N score less than 4.83 indicated inadequate HL. The sensitivity of the scale was 0.71 and 0.75 when using GS1 and GS2 as gold standard respectively. The specificity of the measurement was 0.69 and 0.75 when using GS1 and GS2 as gold standard respectively. In conclusion, validity, sensitivity and specificity of the THLA-N was satisfactory. However, further studies should be conducted in other groups of subjects to confirm its psychometric properties, cut-off score, sensitivity and specificity.