# Health literacy and prevention behavior for preventing premature pregnancy among ethnic students in Northern Thailand

## TL;DR

This study explores how health literacy affects pregnancy prevention behaviors among ethnic adolescent girls in northern Thailand.

## Contribution

It identifies critical health literacy as a key predictor of prevention behavior, while interactive literacy has a negative impact.

## Key findings

- Participants showed moderate overall health literacy with high decision-making skills but low basic and interactive literacy.
- Critical health literacy positively predicted pregnancy prevention behavior, while interactive literacy had a significant adverse effect.
- The model explained 17.8% of the variance in prevention behavior.

## Abstract

Premature pregnancy among adolescents remains a critical public health challenge, particularly among ethnic populations in low-resource settings. Health literacy has been identified as a key determinant of reproductive decision-making and preventive behaviors. This study aims to assess the levels of health literacy and examine their association with pregnancy prevention behavior among ethnic students in northern Thailand.

A cross-sectional study was conducted with 128 in-school ethnic adolescent girls, using validated instruments to measure health literacy across three domains: basic, interactive, and critical health literacy, and pregnancy prevention behavior. Descriptive statistics, Pearson's correlation, and multiple linear regression were used to analyze the data.

The participants exhibited moderate overall health literacy, with high scores in decision-making skills but relatively low scores in basic and interactive literacy. Pearson's correlation analysis revealed that critical literacy was positively associated with prevention behavior (r = 0.336, p < 0.001), while interactive literacy showed a negative correlation (r = −0.247, p < 0.001). Multiple regression analysis further confirmed these associations. Critical literacy significantly predicted pregnancy prevention behavior (β = 0.438, p < 0.001), whereas interactive literacy had a significant adverse effect (β = −0.568, p < 0.001). The model explained 17.8% of the variance in behavior (R2 = 0.178).

The findings underscore the importance of critical health literacy in fostering preventive behaviors among ethnic adolescents. Tailored interventions should emphasize evaluative and judgmental skills while addressing culturally rooted communication challenges. These insights may inform inclusive reproductive health policies in ethnic and underserved communities.