Does Health Literacy Predict Preventive Lifestyle on Metabolic Syndrome? A Population-Based Study in Sarawak Malaysia

Abstract

Poor health literacy (HL) is a risk factor for developing metabolic syndrome. In Malaysia, about 93% of adults' population has limited HL-a huge prevalence yet understudied phenomenon. This study aims to determine the predictors of preventive lifestyles on metabolic syndrome among adult population in Sarawak are timely. This was a population-based study, conducted from September 2016 till December 2017 using a multistage stratified sampling method. Health Literacy Scale and Simple Lifestyle Indicator Questionnaire were used to measure health literacy and preventive lifestyles respectively. Analysis of Variance and logistic regression were used to analyze the data. A total of 743 respondents were involved in this study with half of them have acceptable score for health literacy (M = 46.9, SD = 6.3) and good preventive lifestyles (M = 7.3, SD = 1.4). Critical health literacy was a significant influence of preventive lifestyles. The Malay ethnic group has the highest scores for both critical health literacy [F (3, 739) = 17.82, p < 0.001] and preventive lifestyle compared to other ethnic groups [F (3, 739) = 3.12, p = 0.025]. The other Native groups scored the lowest for critical health literacy. Individual with higher score of critical health literacy tend to perform physical activities. Gender, education level, distance of health facilities, critical health literacy and employment status were identified as predictors for preventive lifestyle in this study. Health literacy is a key to preventive lifestyle behaviors in metabolic syndrome among adult population in Sarawak. Future program should focus on improving HL status with specific program targeting ethnic minorities.

Associations between Health Literacy and Sociodemographic Factors: A Cross-Sectional Study in Malaysia Utilising the HLS-M-Q18

“…Res. Public Health 2021, 18, 4860 2 of 11 associated with positive health outcomes [5], healthy behaviours [5,6], and lower health costs [7]. It is plausible to expect that the way forward to realise better global health management is to improve society's health literacy levels.…”

Associations between health literacy and sociodemographic factors: A cross-sectional study in Malaysia utilising the HLS-M-Q18

“…Three states were selected (Selangor, Kuala Lumpur and Sarawak) to represent the distribution of multiple ethnicities, as well as the distribution of urban and rural areas. The selection of areas was made based on referral and advice by the District of Jurisdiction Malaysia, Rural Master Plan Malaysia, and previous literature [15].…”

Establishing the HLS-M-Q18 short version of the European health literacy survey questionnaire for the Malaysian context

“…Three states were selected (Selangor, Kuala Lumpur and Sarawak) to represent the distribution of multiple ethnicities, as well as the distribution of urban and rural areas. The selection of areas were made based on referral and advice by the District of Jurisdiction Malaysia, Rural Master Plan Malaysia, and previous literature [9].…”

“…Selection of the three states was decided upon discussion between researchers and the Ministry of Health Malaysia.In stage two, researchers utilised cluster sampling to determine districts of choice. District sampling for Selangor was determined based on the demographic distribution list published by the Selangor Economic Development Unit, as well as extant literature[9].For selection of districts in Kuala Lumpur, researchers used data provided by the Department of Information, Ministry of Communications and Multimedia Malaysia; and for selection of districts in Sarawak, the selection of districts was guided by data provided by the State Director of the Fire and Rescue Department. The definitions of rural and urban were determined by the National Department of Statistics and The Rural Master Plan, published by the Ministry of Rural Development Malaysia.…”