Studying On Health Literacy And Its Influencing Factors Among Medical Students In A Medical University

Background Health literacy usually refers to the ability of individuals to obtain,process,understand and use basic health information and services,and to make appropriate health decisions,maintain and promote their own health.As the future medical service providers,medical students' health literacy plays an important role in health and health services.As early as 1990 s,foreign countries have begun to study of medical students' health literacy.However,research on health literacy of Chinese medical students is scarce.Objective The aim of this study was to survey the health literacy level of medical students in Chongqing,China,and its influencing factors.And provide the reference for improving medical students' health literacy.Methods We did a cross-sectional study by stratified cluster sampling of 1737 medical students who majored in six different disciplines(clinical medicine,nursing,preventive medicine,food hygiene and nutrition,biomedical engineering and rehabilitation therapy)at the medical university in Chongqing,China.Investigation time was from March 23,2015 to April 17,2015.We used the health literacy questionnaire(HLQ)to assess health literacy,which was designed by Osborne and its team in Deakin University in Australia.The questionnaire has been shown to have strong construct validity,reliability and acceptability in several countries.And the questionnaire was used in mainland China for the first time.The questionnaire including the following 9 domains:(1)Feeling understood and supported by healthcare providers(16 points);(2)Having sufficient information to manage my health(16 points);(3)Actively managing my health(20 points);(4)Social support for health(20 points);(5)Appraisal of health information(20 points);(6)Ability to actively engage with healthcare providers(25 points);(7)Navigating the healthcare system(30 points);(8)Ability to find good health information(25 points);(9)Understand health information well enough to know what to do(25 points).Cronbach alpha coefficient,exploratory factor analysis and confirmatory factor analysis were used to test the reliability and validity of the questionnaire.Analyses were done with t-test,ANOVA,?2 tests,Pearson correlation analysis,and multiple linear regression models.Results 1 The general Cronbach ?=0.933;KMO= 0.964,Bartlett test P<0.0001,the 9 domains of the cumulative contribution rate was 60.64%;the GFI was 0.881,CFI was 0.899,the RMR was 0.024.2 The health literacy status of medical students: the total score of HLQ was 131.89±18.86.The scores of HLQ in nine scales were 8.57±2.31,10.18±1.93,13.10±2.40,14.49±2.15,13.02±2.32,16.87±3.57,19.64±4.10,17.59±3.14 and 18.28±3.00,respectively.3 The influence factor of medical students' health literacy in 9 domains:(1)The influence factors of scale 1(feeling understood and supported by healthcare providers)were: living area,socioeconomic status,and parents' highest education level.(2)The influence factors of scale 2(having sufficient information to manage my health)were: living area,socioeconomic status,parents' highest education level,and long-term illness or disability.(3)The influence factors of scale 3(actively managing my health)were: socioeconomic status,parents' highest education level,long-term illness or disability,and grade.(4)The influence factors of scale 4(social support for health)were: gender,socioeconomic status,long-term illness or disability,and grade.(5)The influence factors of scale 5(appraisal of health information)were: socioeconomic status,long-term illness or disability,and parents' highest education level.(6)The influence factors of scale 6(ability to actively engage with healthcare providers)and 7(navigating the healthcare system)were: living area,socioeconomic status,long-term illness or disability,and specialty.(7)The influence factors of scale 8(ability to find good health information)were: socioeconomic status,long-term illness or disability.(8)The influence factors of scale 9(understand health information well enough to know what to do)were: gender,socioeconomic status,and long-term illness or disability.Conclusions The health literacy questionnaire(HLQ)was proved to have good reliability and validity in this medical students' health literacy study.The overall score was 131.89±18.86(scoring rate was 66.9%),and the medical students in the scale 1(health care providers to understand and support)scored lowest.Gender,living area,socioeconomic status,parents' highest education level,long-term illness or disability,grade and specialty have impacts on health literacy of medical students.