Study On Primary School Students' Health Literacy Evaluating Index And Its Application In Shanghai

As a kind of individual abilities to maintain the health,health literacy decides the residents' life quality and health level to a great extent.Many countries in the world put the health literacy as an effective way to promote national health,and they want to strengthen research and formulate the relevant policies or measures,try to through this kind of economic and effective way to realize people' s long-term health improment.At the same time,China attaches great importance to the important role of health literacy for citizen's health.With the support of a series of policy and related work to carry out,health literacy becomes a long-term and constantly perfected policy for our government to improve the national health level.But the emphasis of the strategy mainly focus on the adult people,there aren't the unified evaluation tool and the nationwide investigation for the health literacy of children and adolescents including primary school students.Although the body and psychology of the age group are not yet mature,but they have the high plasticity,so the formation of ideas and actions in this age period will affect their whole life cycle.From what has been discussed above,we should focus on the health literacy of the primary school students and provide powerful basis for making policy and implement interventions through exploring a scientific and reasonable evaluation tool to master status and found the problem.ObjectiveIn order to assessment the primary school students' health literacy level scientificly,reasonably and accurately,we will construct the evaluation index and determine the weight of indexes.Finally,we will design the questionnaire on the basis of previous research.The questionnaire will be used to master the health literacy level and analyze the effect factors and put forward targeted suggestions or measures in order to provide relevant departments with basis for making scientific and effective health literacy improvement strategies.MethodsCombining with the characteristics of pupils and their health problems,we use the literature research and Delphi to construct the evaluation index and apply the AHP to determine the weight of indexes.By adopting the method of multistage sampling,extract 430 pupils of grade five from five schools in Shanghai for questionnaire survey.The survey cotent has three parts including their basic information,health literacy assessment and evaluation and demand about health education.Use the the method of descriptive statistics to analyse the primary school students' health literacy current and demand about health education.Use T test and F test to analyse the students' health literacy scores with different characteristics.Use ?2 test and multi-factor regression analysis to discuss the affect factors,inspection level ?=0.05.Results1.Construction of evaluation index and design of questionnaire.(1)This section has constructed the evaluation index including “health belief and knowledge”,“ health lifestyle”and “health basic skills”,we called them “three dimensions”.There are 53 secondary indicators involving “health consciousness”,“prevention of chronic disease”,“prevention of infectious disease”,“safety and emergency”and “adolescence and health care”,we called them “five kinds of field”.(2)This section were conducted two rounds of expert consultation,and the recovery rates of two rounds consultation questionnaire are all above 90%,experts' enthusiasm is high.At the same time,the authority coefficients in two rounds consultation are all above 0.8.Three dimensions' Kendall coefficient is higer than the first round,they are respectively0.365,0.373,0.444,and all have statistical significance(P?0.05).(3)This section used AHP to determine the indexes' weight,and the consistencyresult is good.Therefore,the calculation results can be used for evaluation.(4)The questionnaire was designed according to the principle of rationality,practicability,objectivity and voluntary,therefore it is scientific and effective,thefeasibility is good.2.Analysis of the health literacy situation of pupils in Shanghai.(1)In the survey,the primary school students' possess rate of overall health literacy is 49.07%,and the average score of it is 78.96±12.56.The health literacy possess rates in three dimensions are respectively 43.02%,58.84%,45.12% and the average scores of them are respectively 19.23±4.26?33.75±5.44?25.99±5.21.The health literacy possess rates in five kinds of field are respectively 61.86%,27.91%,39.77%,54.19%,53.26% and the average scores of them are respectively 11.00±2.26?10.99±2.74?11.90±3.00?30.70±5.88?8.63±1.37.(2)Health literacy scores have the significant difference in gender,nationality,self-reported health status,parents' education,parents' drinking and smoking behaviors,family income and school district.The students whose gender is girl,nationality is Han,self-reported health status is better,parents have good education,parents have no smoking and drinking behaviors,family income is higher and school is in city center get higer scores.(3)In the survey,77.74% of students think the health education is important to their health,15.51% of them think the importance is general,and 6.05% of them think it isn't important.At the same time,29.77% of students are satisfied with the content and form of health education while 17.90% of them think it is unsatisfactory and 52.33% of them think it is general.According to the selected number,the way to obtain health knowledge for primary school studens is respectively health education course in school,relatives and friends,books of newspaper,television and radio,health publicity column or manual,Internet or mobile phone,health lecture.3.Analysis of the health literacy influence factor for pupils in Shanghai.(1)After the ?2 test and multi-factor regression analysis,we can know that the influence factors of overall health literacy are if students are the one-child,if parents have the smoking behavior,if school is in city center.About health literacy in three dimensions,the influence factors of health belief and knowledge are gender,parents' smoking behavior and school district.The influence factors of health lifestyle are their father's smoking behavior.Health basic skill has 2 influence factos,including the self-reported health status and the mothers' education.(2)About health literacy in five kinds of field,the influence factors of health consciousness are fathers' smoking and drinking behaviors,mothers' smoking behavior.The influence factors of prevention of chronic disease are the one-child status,mothers' smoking behavior and school district.The influence factors of prevention of chronic disease are the one-child status,mothers' smoking behavior and school district.The influence factors of prevention of infectious disease are gender,the one-child status,fathers' smoking behavior.The influence factor of safety and emergency are the fathers' smoking behavior.The literacy of adolescence and health care has 2 influence factos,including gender and mothers' smoking behavior.(3)In the all of influence factors,girl,one-child,good self-reported health status,mothers with better education,parents without smoking and drinking behavior are the promoting factor to health literacy.Countermeasures and Suggestions1.About the government and societyAttach a great importance to the students' health literacy and optimize the environment of policy support.Protrude the community's social responsibilitity and widen the channel of the health education.Give full play to their role as the medium of communication and improve the efficiency of health promotion.Expand the scope of the people and promote students' health literacy monitoring work.2.About the schoolImprove the mechanism of school health education and enrich the content of innovation and form.Focus on students' weak links and improve overall health literacy's cultivation.Around the key crowd and make the science promotion strategies.3.About the familyPay attention to the upgrade from parents own health literacy.Guide parents to develop a healthy lifestyle.Establish the interactive and jointly promote health literacy mode among family,community and school.