| Background:The health level of adolescents is not only related to the health and happy life of individuals,but also to the future health quality of the entire country,The health of young people plays an important role in the national strategy in China.Teenagers take on more responsibility for their health during adolescence,and adolescents in China are facing new health problems and challenges that are constantly emerging,and health problems such as overweight and obesity,metabolic abnormalities,mental health problems,myopia,and dental caries are gradually prominent.Health empowerment is a prerequisite for health,the improvement of health literacy can provide a capacity basis for individual health empowerment,health education is the best means to improve the health literacy of adolescents to empower them,China has comprehensively promoted health education and activities to promote health literacy among pupils at the national level.Health literacy is not only the most basic,economic and effective way to realize health and sustainability.But also can be used as a measurement index for health education outcomes.The premise of health literacy research is to be able to scientifically measure the level of health literacy,but compared with the maturity of adult health literacy assessment methods and the abundance of tools,the current scales of adolescent health literacy research at home and abroad are immature,and the few related studies have not yet applied project response theory.Objective:This study aims to further clarify the connotation of adolescent health literacy,construct a health literacy assessment system applicable to junior middle school adolescents in China,develop a special health literacy assessment questionnaire and comprehensive health literacy assessment questionnaire for nutrition,exercise and eye care for junior middle school adolescents in China,explore the reliability and validity of their application to junior high school students in China,and screen the entries,so as to achieve accurate and rapid assessment of the health literacy of the target population.The multi-theme research on health literacy measurement tools provides scientific reference and reference.Methods:Based on summarizing and referring to domestic and foreign related theories and studies,the connotation and characteristics of adolescent health literacy were clarified.Combined with relevant domestic policy guidance and the health status and problems commonly existing in China’s adolescent groups,using a combination of quantitative and qualitative research methods,The evaluation system of health literacy of junior middle school students was established by means of documentary,expert interview and group discussion,Delphi method,and percentile weight method,and the health literacy assessment tools for junior high school students in China,including nutrition,exercise,eyesight Health Literacy Assessment Questionnaire and Comprehensive Health Literacy Assessment Questionnaire.The questionnaire was tested on the spot in a district and a suburban district of the city(district)in which the survey was conducted.The project response theory,using Rasch model Analysis and Classic Measure Theory,Analysis of Quality,Reliability and effectiveness of the questionnaire and questionnaire elements were reviewed to conduct research on rapid assessment methods and technologies.Results:This study believes that adolescent health literacy refers to the ability of individual adolescents to acquire and process basic health information and take action to influence their own and others’ health decisions and health well-being through reasonable autonomy and understanding and using a wide range of knowledge and skills in different situations in healthy environments and daily life environments.In this research,we set up a health literacy evaluation system of Chinese junior middle school students,which consists of 7 first-level indexes,20 second-level indexes.And four dimensions of knowledge literacy capacity,behavior,skills and motivation set under each level,these include personal hygiene,nutrition,physical activity,disease prevention and control,security,mental health,and eHealth,with weights based on four dimensions of literacy.Power coordinates in both regions were 0.88 and 0.95,and concentration consistency and coordination improved,moreover,the mean of significance and suitability of all dimensions and indicators of Delphi were>3.5 and CV was less than 0.25,so the expert opinion was reliable.The first-level indicators "physical activity","mental health" and the secondary indicators below them have higher weights.In this study,a series of health literacy questionnaires for Chinese junior high school students,including nutrition,exercise,and eye protection three editions of special health literacy assessment questionnaires and comprehensive health literacy assessment questionnaires,were developed,and rapid assessment methods and technologies were innovatively used to use project response theory and Rasch model.The single-dimensional test of the second classification of the 4th version of the questionnaire basically passed,the reliability of the entries was 1,and the discrimination degree was much greater than 2,and the questionnaire was stable and could distinguish the participants well.Most of the Whitechart competency levels of each questionnaire were normally distributed,and the questions were evenly distributed,but the correspondence between participants and entries was not ideal.The IMNSQ values of most items were in the range of 0.5～1.5,and the fitting between the questionnaire data and the model was generally good.The overall Cronbach’s a coefficient of the 4th edition questionnaire class entries was>0.8,and the content validity and structural validity were good based on Spearman correlation analysis and hierarchical exploratory factor analysis.2 items were removed from the final nutrition questionnaire;3 items were deleted from the sports knowledge dimension,5 items were deleted from the behavior dimension,5 items were deleted from the motivation dimension,and 3 items were deleted from the influencing factor dimension.4 items were deleted from the eye protection knowledge dimension and 2 items were deleted from the skill dimension.One item was deleted from the comprehensive questionnaire knowledge dimension,and the motivation dimension was structured.Conclusion:This study combines a variety of quantitative and qualitative scientific research methods to construct a set of health literacy assessment system suitable for junior high school students in China,and forms a series of special and comprehensive health literacy assessment questionnaires,which have good feasibility and reliability validity,And fill in related research gaps.The evaluation tool can be used as a reference for the implementation of the National Youth Health Literacy Monitoring System,The construction and assessment of health promotion schools,as well as the application of IRT and Rasch models,as well as the new methodology,will be helpful to further study of multi-population and multi-subject health literacy measures in China. |
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