Validating the Short-Form Health Literacy Questionnaire (HLS-SF12) and Assessing Health Literacy Among the Temiar Orang Asli

Health literacy is essential for achieving positive health outcomes, particularly in marginalized communities. The Orang Asli, specifically the Temiar sub-tribe in Malaysia, face unique challenges due to geographic isolation and cultural barriers. The research focused on determining health literacy rates among the Temiar Orang Asli through the Health Literacy Short-From 12 (HLS-SF12) while testing its applicability for this population. Research was conducted through a cross-sectional study with 404 Temiar Orang Asli adults from Kuala Kangsar, Perak, Malaysia. The assessment of health literacy utilized the Malay version of the HLS-SF12 measurement tool. The tool's construct validity was evaluated through confirmatory factor analysis (CFA) while internal consistency was measured using Cronbach’s alpha. The study explored the relationships between sociodemographic characteristics and health literacy levels by using both simple and multiple linear regression analysis methods. Most participants (53.0%) demonstrated inadequate health literacy, while 31.4% had problematic levels. Only 13.4% had sufficient health literacy, and 2.2% achieved excellent levels. The model fit analysis yielded acceptable results (RMSEA = 0.08, GFI = 0.94, CFI = 0.94) while Cronbach’s alpha levels between 0.75 and 0.88 across domains showed that the assessment tool was valid and reliable for this population. Higher education emerged as the only independent predictor of improved health literacy in the multiple regression analysis (β = 4.08, 95% CI: 2.69 to 5.46, p < 0.001). These findings confirm that the HLS-SF12 tool effectively measures general health literacy for the Temiar Orang Asli community and highlight the need for culturally adapted health literacy initiatives, particularly those focused on educational outreach, to improve health outcomes in this vulnerable population.