Executive Summary of the Thai Health Literacy Survey Tool (HLS-TH-Q87) 1. Background and Localization The HLS-TH-Q87 was developed as a specialized adaptation of the European HLS-EU-Q47 to measure health literacy among the Thai population aged 15 and older . While it maintains the foundational framework of the original European model, it incorporates significant modifications to address specific health challenges and cultural contexts within Thailand . 2. Key Structural Enhancements The Thai version expands the traditional health literacy matrix in two primary ways: Expansion of Care Dimensions: A fourth dimension, Health Products, was added to the existing three (Health Care, Disease Prevention, and Health Promotion) . This addition was necessary due to widespread local issues regarding the misuse of herbs and health supplements driven by social media, digital TV advertising, and word-of-mouth . Addition of Process Dimensions: A fifth process dimension, Inquiry, was integrated alongside Access, Understand, Appraise, and Apply . This measures an individual’s ability to proactively seek clarification and ask questions regarding their health . 3. Focus on Practical Application and Task-Based Items A defining feature of the HLS-TH-Q87 is its heavy emphasis on the Apply dimension, which contains 41 items compared to the 11 items in the European version . Rather than focusing solely on basic skills (Skill-based), the Thai tool focuses on specific practical tasks and issues (Task-based/Issue-based) derived from the 66 Key Messages of the Thai Health Literacy Association . 4. Tool Composition and Scoring Standards The survey is divided into three sections: General Data (10 items), Health Data (8 items), and Health Literacy Data (87 items) . Total Scoring: The health literacy section has a maximum possible score of 348 points . Proficiency Threshold: The cut-off point for a Sufficient level of health literacy is set at 75 percent, or 261 points . Individuals scoring below this threshold are categorized as having Inadequate health literacy . 5. Statistical Validity and Health Implications Research and quality testing have confirmed that the HLS-TH-Q87 possesses high internal consistency, with Cronbach’s alpha coefficients exceeding 0.70 across all components . Crucially, survey results have shown a significant statistical correlation with actual health outcomes: individuals with lower health literacy scores are significantly more likely to suffer from chronic diseases and abdominal obesity