Measuring the health literacy level of Arabic speaking population in Saudi Arabia using translated health literacy instruments

Background: Health literacy is an essential predictor of health status, disease control and adherence to medications. Objectives: The study goals were to assess the health literacy level of the general population in Saudi Arabia using translated Gulf Arabic version of the short-version of the Test of Functional Health Literacy in Adults (S-TOFHLA) and Single Item Literacy Screener (SILS) tests and to measure the relationship between health literacy and education level. Methods: The study was a cross-sectional with a convenience sample of 123 participants from the general population in Riyadh. Data were collected using the modified (Gulf) Arabic versions of both S-TOFHLA and SILS. Fisher's Exact test was used to measure the difference of the health literacy scores according to the education degrees and Cronbach's alpha was used to measure the internal consistency of the S-TOFHLA items. Results: More than half (55.4%) of the participants were male, 50.4% had a middle school or less education level, and we found that 84.4% had adequate health literacy as measured by the S-TOFHLA, compared to 49.6% as measured by SILS. The Fisher's Exact test showed a significant difference (P<.05) in the S-TOFHLA and SILS scores according to education categories. Conclusions: The level of education has a significant positive association with S-TOFHLA and SILS results. The Gulf Arabic version of S-TOFHLA is a reliable test with a good internal consistency and a significant positive correlation between the two parts of S-TOFHLA. We recommend the use of S-TOFHLA or SILS at the first patient visit.