A Study Of 5999 Citizens' Health Literacy In Several Areas In Hunan Province

objective:To understand citizens'health literacy status in several areas in Hunan, and explore the influencing factors of health literacy. Futhermore, we intended to test a model in which health skills mediated the effects between health knowledge and health behaviors. The study will provide evidence to develope measurements which aims to enhance citizens'health literacy.Methods:Face to face interview was conducted among 5999 citizens randomly selected in several areas in Hunan. T-test and ANOVA were used to test the difference of health knowledge, health skills and health behaviors among people stratified by demographic characteristics. Non-conditional logistic regression models were used to assess the possible influencing factors of citizens'health literacy score. Relationship and hierarchical regression analyses were used to test the relationship between variables. Sobel Z-test was used to explore whether health skills partially mediated the effects between health knowledge and health behaviors with significant difference.Results:The awareness rate of health knowledge, the rate of optimal behaviors and the grasping rate of health skills of all citizens in surveyed areas were 57.7%,52.3% and 55.4%, respectively, and that of urban citizen were higher than rural citizen (63.8% VS 51.6%,62.1% VS 48.8%,57.6% VS 47.0%), the differences all had significance (χ2=164.203, P=0.000;χ2=533.000, P=0.000;χ2=946.216, P=0.000). Non-conditional logistic regression analysis results show:minority nationality (OR=1.906),rural areas (OR=1.835),heavy manual (OR=1.550) and more resident population(OR=1.061) had the relatively low health literacy, female(OR=0.868),college/undergraduate and above (OR=0.089) and family income was 5000-9999￥(OR=0.282) had the relatively high health literacy. Health knowledge and health skills were significantly related (r=0.577,p< 0.01); health skills and health behaviors were significantly related (r=0.617,p< 0.01); health knowledge and health behaviors were significantly related(r=0.677,p< 0.01). Hierarchical regression analyses provided evidence that the addition of health skills reduced the links between health knowledge and health behaviors (βfrom 0.607 to 0.455). Sobel Z-test predicted that health skills partially mediated the effects between the kealth knowledge and health behaviors among citizens in several areas in Hunan with significant difference(βfrom 0.607 to 0.455, Z=25.92, P< 0.001).Conclusions:The health literacy levels of the citizens in surveyed areas need further enhance and we should pay attention to the influencing factors and the mediating effect of health skills between the health knowledge and health behaviors. Necessary health education intervention should be taken in order to enhance citizens'health literacy.