THE RELATIONSHIP BETWEEN MEDIA LITERACY AN D TUBERCULOSIS HEALTH LITERACY: A CROSS-SECTIONAL PLS-SEM ANALYSIS IN SURAKARTA CITY AND KARANGANYAR REGENCY, INDONESIA

Abstract

Despite persistent inequities in access to health information, the burden of tuberculosis (TB) in Indonesia remains considerable. This study aimed to examine the influence of media literacy (ML) on health literacy (HL) related to TB prevention among rural and urban populations. A quantitative cross-sectional survey was conducted among 325 adults (110 males and 215 females) in Central Java, comprising 170 rural and 155 urban participants selected through a two-stage random sampling approach, with purposive site selection based on stratified random criteria. ML was assessed using the UNESCO framework for Media and Information Literacy, while HL was measured with the HLS-EU-Q instrument. Data were analysed using Partial Least Squares Structural Equation Modeling (PLS-SEM) and Multi-Group Analysis (MGA) to explore rural–urban differences. The average HL score ranged from 24.4 to 24.8 (inadequate), while ML ranged from 25.1 to 25.3 (problematic). ML exerted a significant direct effect on HL (β = 0.43, p < 0.001), explaining 20% of its variance (R² = 0.20). The model demonstrated an acceptable fit (SRMR = 0.058), and no significant rural–urban differences were identified (Δβ = 0.05, p = 0.616), indicating structural invariance. These results suggest that strengthening ML enhances individuals’ capacity to access, evaluate, and utilize TB-related information effectively across diverse contexts. Media literacy constitutes a critical determinant of health literacy across geographical settings. Incorporating ML training into community health worker education, digital health interventions, and validated media content could promote equitable health communication and reinforce TB prevention outcomes in Indonesia.