Health Literacy and Factors Associated with Tuberculosis Prevention Behaviors Among the Elderly in Yasothon Province

Abstract

This study aimed to assess health literacy, preventive behaviors, the prevalence of tuberculosis risk groups, and factors associated with tuberculosis preventive behaviors among older adults. A crosssectional analytical study was conducted from October 2024 to September 2025 among 575 individuals aged 60 years and older, selected using multistage sampling. Data were collected using a validated questionnaire and analyzed using descriptive statistics and multiple binary logistic regression. The results showed that most participants had a moderate level of health literacy (48.5%), while a high level of tuberculosis preventive behaviors was observed (63.8%). The prevalence of tuberculosis risk groups was 62.4% and the highest prevalence observed in the 70–79 age group (68.5%). Marital status and health literacy were significantly associated with tuberculosis preventive behaviors (p < 0.05). Participants who were divorced, widowed, or separated were more likely to engage in preventive behaviors than those who were married (AOR = 1.9, 95%CI: 1.0–3.5). Additionally, participants with high and moderate levels of health literacy were more likely to demonstrate preventive behaviors compared to those with low health literacy (AOR = 3.2, 95%CI: 2.1–5.9; and AOR = 1.5, 95%CI:1.1–2.4, respectively). Despite generally favorable preventive behaviors, health literacy remained at a moderate level, and more than half of the participants were still classified as at risk for tuberculosis. These findings highlight the need for integrated interventions, including targeted screening among high-risk groups particularly older adults aged ≥70 years and those with marital partners along with strengthening health literacy and designing context-specific, family-oriented interventions.