Development and validation of the health literacy assessment tool for older people in Taiwan: Potential impacts of cultural differences

Purpose: To screen health literacy among urban elderly in Taiwan, who cannot be evaluated easily using the current measurement tools because of the "face", which meant someone felt embarrassed if he did not know how to do something. Materials and methods: A literature review was performed to define a framework for developing the health literacy screening tool. Two hundred elderly were recruited to test the validity and reliability for pilot study. One thousand and eighty two elderly who came from quota sampling in Taipei City by administrative areas and gender were interviewed face-to-face to gather health literacy performance by the developed health literacy screening tool and the short-form Mandarin Health Literacy Scale (s-MHLS). Results: 10-items of health literacy screening tool by self-perception were developed. The mean score of screening tool among analysis sample was 42.3 (0-50) and s-MHLS was 9.5 (0-11). Pearson correlation coefficient was 0.441 (p<0.0001) between these two measurements. Multiple regressions showed that, female, younger, higher education, living with family, has no primary caregiver, has few medical companionship, and higher score of health knowledge had better health literacy performance in both measurements. Conclusions: This screening tool should be applied to screen health literacy of elderly came from baby boomer who usually have lower education levels than the general population in Chinese regions.