Validity of Environmental Health Literacy Scale for Homebound and Bedbound Elder of Village Health Volunteer

Abstract

Background: The goal of global environmental health is to increase health literacy. The elder is the group that has lower health literacy. The health volunteers can support them to improve this aspect. Objective: To develop an environmental health literacy (EHL) scale and examine a causal relationship model of environmental management behavior (EMB). Materials and Methods: The cross-sectional study of 454 village health volunteers that were selected by a quota cluster random sampling. Data were collected through the five points Likert rating scale questionnaire. A confirmatory factor analysis (CFA) and a structural equation model (SEM) were conducted by LISREL software. Results: The quality assessment of the EHL consisted of 25 items and four key components. Those components are accessible, understanding, assessment, and decision-making. The EHL has a high acceptable reliability (alpha=0.91 to 0.93), validity (IOC 0.80 to 1.00), and factor loading (0.50 to 0.84). The EHL measurement model on the development and validation sample fit the empirical data. All factors can explain EHL and EMB of total sample with variance of 80% and 69%, respectively. The environmental literacy (EL) directly influenced EHL (beta=0.90), EL, and EHL directly, which influenced awareness of environmental management for the elder (beta=0.35 and 0.28, respectively). Additionally, EHL and awareness of environmental management directly influenced EMB towards the homebound and bedbound elder (beta=0.34 and 0.59, respectively) at significance level of 0.05. Conclusion: The EHL scale should be used to encourage EMB towards the homebound and bedbound elder among village health volunteers. Keywords: Environmental health, Health literacy, management, Health volunteer, Homebound, Bedbound, Elder