National Survey Of Adult Health Literacy And Assessment System Establishment In China

ObjectiveHealth literacy represents the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions in ways which promote and maintain good health.It's very important to establish assessment system of health literacy and investigate the status of public health literacy.This study was designed to select the index system on health literacy,establish health literacy comprehensive evaluation model,investigate the health literacy status of China public,mobile populations and military,find the influence factors of health literacy, and analyse the effects of health literacy on utilization of health services.MethodsIn this study,a multi-stage stratified sampling method was carried out to select the sample population in the six provinces of China,which were about 12,000 adults aged 18-69 years old.At the same time,cluster sampling method was used to sample 2,000 people of mobile populations and 900 soldiers.Questionnaire survey on health literacy was conducted among these samples.In this study,subjective weight was given based on Glmethod,and objective weight was obtained from entropy method.Comprehensive assessment index model of health literacy was established through the combination of objective and subjective weight,and the evaluation of the model was carried out by using the survey data.Descriptive analysis,correlation analysis and polytomous logistic regression on ordinal response model were used to analyze characteristics and impact factors of different people's health literacy,and the effects of low health literacy on utilization of health services. ResultIn this study,three sample population including nation adults,soldiers and mobile populations were conducted questionnaire survey,the effective recovery were 99.4%, 89.0%,99.1%,repectively,and the Myer's index of national adult sample was 4.92.There were 40 items screened which weight were calculated to establish the health literacy comprehensive assessment system including four partial index:health knowledge,health behavior,health belief and functional health literacy.The reliability coefficient of assessment system was 0.847 for internal consistence(Cronbachα)and the discriminant validity was good by Cluster analysis(F=38730.86,P＜0.01).Among different groups of people,the health literacy comprehensive index shows that the soldiers' index(5.58±0.79) and Urban residents' index(5.50±0.89)were higher than others,while the level of the floating population health literacy(5.25±0.94)was lower than that of urban residents Literacy,and the rural residents' index was lowest(4.49±0.99).Education and income were found as the main factors of affecting population health literacy(P＜0.01)by using correlation analysis and logistic regression analysis.The people with low health literacy had lower willingness of participate in the commercial medical insurance,and can not effectively access to health information and services.ConclusionThe reliability and validity of health literacy assessment system meet the requirements of study,and the health literacy comprehensive index model can well assess the health literacy status of different groups.The assessment index model is a credible and scientific tool for future development of health literacy assessment criteria and fills in the gaps about theory and technology in this field.The study shows that the most important influence factor of health literacy is education in China,and it is evidently different in use of health information and service among different health literacy level groups.The study has provided the data and theories support for making health education and health promotion strategies and seeking the intervention sites of health literacy.