Factors associated with fall prevention-related health literacy practices among community-dwelling older adults in Northern Thailand: a cross-sectional study.

内容摘要

Falls are a major public health concern among older adults and contribute substantially to disability, reduced quality of life, and increased healthcare burden. Fall prevention-related health literacy practices, reflecting the application of health literacy skills in daily life, may influence an individual's ability to recognize risk factors and adopt appropriate preventive behaviors. This study aimed to examine factors associated with fall prevention-related health literacy practices among community-dwelling older adults in Northern Thailand. A community-based cross-sectional study was conducted among 415 older adults residing in Chiang Rai Province, Thailand, between February to May 2025. Participants were selected using a multi-stage stratified sampling approach. Data were collected through structured questionnaires assessing sociodemographic characteristics, fear of falling, and fall prevention-related health literacy. Functional mobility was evaluated using the Timed Up and Go (TUG) test. Data were analyzed using IBM SPSS Statistics for Windows, Version 29.0 (IBM Corp., Armonk, NY, USA). Multivariable logistic regression analyses were performed to identify factors independently associated with adequate fall prevention-related health literacy and its subdomains. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Most participants were female (58.3%), and 61.9% were aged 60-69 years. Overall, 88.70% demonstrated inadequate fall prevention-related health literacy. Housing characteristics (AOR = 3.166, 95% CI: 1.505-6.660) and TUG performance (AOR = 0.352, 95% CI: 0.163-0.761) were significantly associated with adequate fall prevention-related health literacy. Housing characteristics were consistently associated with access (AOR = 1.959, 95% CI: 1.168-3.284), cognitive (AOR = 2.055, 95% CI: 1.203-3.511), communication (AOR = 2.125, 95% CI: 1.233-3.665), and self-management skills (AOR = 1.830, 95% CI: 1.095-3.059). TUG performance was significantly associated with access and cognitive literacy. Additionally, cognitive literacy was significantly associated with marital status and fear of falling, while education level was significantly associated with self-management (AOR = 0.504, 95% CI: 0.296-0.861) and media literacy (AOR = 0.342, 95% CI: 0.211-0.556). A substantial proportion of community-dwelling older adults had inadequate fall prevention-related health literacy. Environmental and functional factors were consistently associated with health literacy across multiple domains, with additional associations for marital status, educational attainment, and fear of falling. These findings highlight the need for community-based fall prevention strategies incorporating adapted health communication, environmental modification, mobility assessment, and targeted interventions to strengthen preventive capacity among older adults. Not applicable.