Analysis Of Scientific Literacy For Seeking Medical Care Among Residents From 2017 To 2020

Objective:This study aimed to understand the current situation and changing trend of Taizhou residents’ scientific literacy for seeking medical care,analyze its main influencing factors,weak groups and weak knowledge points,explore the effects,problems and improvement suggestions of health education strategies at different levels,and to put forward targeted strategies to improve residents’ scientific literacy for seeking medical care,so as to provide a valuable reference for health development plans.Methods:This study adopted a combined method of multi-stage random sampling and cluster sampling proportional to population size(PPS).From 2017 to 2020,4 streets/towns were selected from each of 9 counties/cities/districts in Taizhou,2 neighborhood committees/villages were selected from each street/town,1 area(about 750 households)was randomly selected from each neighborhood committee/village,and 50～80 households were randomly selected from each area.One resident aged 15 to 69 years was selected from each household by KISH table method as the investigation object,and the unified National Residents Health Literacy Monitoring Questionnaire was used for the survey.Constitutive ratio or holding rate was used for descriptive analysis,percentage,growth rate and linear trend chi-square test were used for trend analysis,and the binary logistic regression model was used for influencing factors analysis.From the perspective of social ecological health literacy,a combination of offline face-to-face interview and telephone interview was used to conduct semi-structured interviews with local health education staff and residents,and thematic framework method was used to analyze the interview data.Results:(1)From 2017 to 2020,the level of Taizhou residents’ scientific literacy for seeking medical care(after standardized and weighting)was 25.7%,31.4%,35.4%and 38.1%respectively,showing a linear increasing trend(P<0.001).(2)Except for 65～69 years old,illiterate/less literate and workers,the results of linear trend chi-square test of scientific literacy for seeking medical care of other residents with different living areas,gender,age,education and occupation for four consecutive years have significant differences(P<0.05).(3)From 2017 to 2020,the overall correct response rate of the questions of scientific literacy for seeking medical care was 60.9%,66.7%,68.8%and 68.3%respectively.For four consecutive years,the awareness rate of "free access to health knowledge at community health service centers/stations and township health centers/village clinics" was the highest,while the awareness rate of "free health hotline number 12320" was the lowest.(4)Multivariate Logistic regression analysis showed that age,education,occupation,family annual income and household registration were the influencing factors of residents’scientific literacy for seeking medical care(P<0.05).(5)Interviewed health education staff all agree that health education and health promotion strategies from five aspects of the social ecological health literacy model can promote residents’ scientific literacy for seeking medical care,on the premise that the work is implemented in place.There still remained some problems,such as poor health education measures at the individual level,solidified concept of residents’ medical treatment,imperfect personnel,funds and organizational guarantee in the field of health education,and insufficient support of relevant systems and policies.(6)Among the factors affecting residents’ concept for seeking medical care in residents’interviews,the most frequently mentioned factors are those at the level of interpersonal relationship,including communication with doctors,family members,relatives,neighbors and friends,etc.Conclusions:Taizhou residents’ scientific literacy for seeking medical care has improved significantly,but it is still at a low level.Middle-aged and elderly residents,residents with low education level and low income,peasants and workers are the groups with weak literacy,which should be regarded as the key groups in the promotion strategy."Free health hotline 12320","national basic public health services" and "hierarchical medical system"are the weak knowledge points.It is suggested to increase the macro policy level of support,integrate health education and health promotion into all sectors and personnel,strengthen the development and popularization of the appropriate technology and tools of health education,and optimize the supportive environment for residents to actively improve their scientific literacy for seeking medical care.