Health Literacy Needs Among Adults With Prehypertension in Rural Thailand: A Cross‐Sectional Study

Hypertension is a major public health concern, highlighting the importance of prevention among individuals with prehypertension through lifestyle modification and improved health literacy. Although health literacy has been widely assessed at the population level, variations in individual skills and support needs remain less understood. This study aimed to describe variations in health literacy skills and identify subgroups with similar health literacy support needs among individuals with prehypertension. A total of 244 adults with prehypertension were recruited through stratified random sampling by village and gender. Health literacy was assessed using the Information and Support for Health Action Questionnaire (ISHA‐Q). Ward’s hierarchical clustering with squared Euclidean distance was used to identify health literacy profiles, with cluster validity and stability assessed using silhouette width, the Calinski–Harabasz index and bootstrap Jaccard coefficients. Associations with cluster membership were examined using chi‐square tests, with Monte Carlo p values where assumptions were unmet and Holm correction for multiple comparisons. Six clusters were retained. Cluster 1 was characterised by confidence in self‐management, strong responsibility for personal health, and good ability to access and use health information and services. Cluster 2 showed adequate self‐management and health service use, but limited ability to share knowledge, exercise regularly and find health information. Cluster 3 demonstrated adequate self‐monitoring and self‐management, but limited exercise and social support. Cluster 4 showed sufficient knowledge of health services and self‐management, but limited social support. Cluster 5 demonstrated acceptable responsibility for health, but limited ability to share knowledge. Cluster 6 showed limited responsibility for health and health service knowledge, lack of exercise and difficulty using supplements. Education level, occupation type, receipt of health information, and media access channels, including village health volunteers, healthcare providers, posters, and radio, were statistically significantly associated with differences in health literacy across the cluster groups. This study explored the challenges and strengths of six clusters, with subgroup variations, in context‐specific health literacy within a Thai rural community. Understanding these differences enables frontline healthcare workers to design flexible, tailored interventions and support individuals in improving health literacy and adopting healthier behaviours for better health outcomes.