Examining the relationship between health literacy and pesticide protection behaviors among farmers in Thailand

Abstract Background The use of chemical pesticides without proper health literacy (HL) and necessary pesticide protection behaviors (PPB) can result in adverse effects on human health. Methods This study aimed to determine whether there was a correlation between HL and PPB among farmers in Nakhon Ratchasima Province using a random sample of 464 farmers. The structured interviews consisted of three parts: 1. General information, 2. Health literacy (including knowledge, understanding, and other subaspects); and 3. Protective behaviors against chemical exposure. Each part of the questionnaire had a reliability index of 0.60 or greater. The reliability of the second and third parts of the questionnaire was as follows: subsections of part 2 had a Kuder-Richardson (KR-20) coefficient of 0.79 and a Cronbach's alpha (α) coefficient of 0.85–0.86, while part 3 had an α of 0.88. The risk of chemical exposure was assessed using a Cholinesterase Reactive Paper test administered via a fingerprick blood test. The data were analyzed using Spearman correlation and binary logistic regression. The study was reviewed by the Human Research Ethics Committee with the following approval dates: August 9, 2021 and August 9, 2022. Results Most participants had moderate overall HL (48.8%) or PPB (44.6%). There was a statistically significant positive correlation between HL and PPB (rs(478) = 0.70, p < .005). Logistic regression analysis demonstrated that HL was significantly positively associated with PPB (p < .001, OR = 6.57, 95% CI 3.95, 10.94) and was associated with blood cholinesterase levels. Conclusion These findings highlight the need for increased health literacy among farmers in Thailand to ensure correct protection against chemical exposure and reduce the adverse effects of pesticide exposure on human health.