Measuring health literacy regarding infectious respiratory diseases: a new skills-based instrument.

BACKGROUND: There is no special instrument to measure skills-based health literacy where it concerns infectious respiratory diseases. This study aimed to explore and evaluate a new skills-based instrument on health literacy regarding respiratory infectious diseases. METHODS: This instrument was designed to measure not only an individual's reading and numeracy ability, but also their oral communication ability and their ability to use the internet to seek information. Sixteen stimuli materials were selected to enable measurement of the skills, which were sourced from the WHO, China CDC, and Chinese Center of Health Education. The information involved the distribution of epidemics, immunization programs, early symptoms, means of disease prevention, individual's preventative behavior, use of medications and thermometers, treatment plans and the location of hospitals. Multi-stage stratified cluster sampling was employed to collect participants. Psychometric properties were used to evaluate the reliability and validity of the instrument. RESULTS: The overall degree of difficulty and discrimination of the instrument were 0.693 and 0.482 respectively. The instrument demonstrated good internal consistency reliability with a Cronbach's alpha of 0.864. As for validity, six factors were extracted from 30 items, which together explained 47.3% of the instrument's variance. And based on confirmatory factor analysis, the items were grouped into five subscales representing prose, document, quantitative, oral and internet based information seeking skills (χ(2) = 9.200, P>0.05, GFI = 0.998, TLI = 0.988, AGFI = 0.992, RMSEA = 0.028). CONCLUSION: The new instrument has good reliability and validity, and it could be used to assess the health literacy regarding respiratory infectious disease status of different groups.

Determinants of health literacy and health behavior regarding infectious respiratory diseases: a pathway model.

BACKGROUND: Health literacy has been defined as the degree to which individuals have the capacity to obtain, process, and understand the basic health information and services needed to make appropriate health decisions. Currently, few studies have validated the causal pathways of determinants of health literacy through the use of statistical modeling. The purpose of the present study was to develop and validate a health literacy model at an individual level that could best explain the determinants of health literacy and the associations between health literacy and health behaviors even health status. METHODS: Skill-based health literacy test and a self-administrated questionnaire survey were conducted among 3222 Chinese adult residents. Path analysis was applied to validate the model. RESULTS: The model explained 38.6% of variance for health literacy, 11.7% for health behavior and 2.3% for health status: (GFI = 0.9990; RMR = 0.0521; χ(2) = 10.2151, P = 0.1159). Education has positive and direct effect on prior knowledge (ß = 0.324) and health literacy (ß = 0.346). Health literacy is also affected by prior knowledge (ß = 0.245) and age (ß = -0.361). Health literacy is a direct influencing factor of health behavior (ß = 0.101). The most important factor of health status is age (ß = 0.107). Health behavior and health status have a positive interaction effect. CONCLUSION: This model explains the determinants of health literacy and the associations between health literacy and health behaviors well. It could be applied to develop intervention strategies to increase individual health literacy, and then to promote health behavior and health status.

[Status of knowledge and behavior of drug use among residents in 5 provinces in China in 2011].

OBJECTIVE: To understand the status of knowledge and behavior of drug use among urban and rural residents in 5 provinces in China to suggest priority intervention strategies and measures for drug use health education. METHODS: From March to May of 2011, 6159 urban and rural residents were selected from Beijing, Liaoning, Zhejiang, Yunnan, Shaanxi provinces by the multistage stratified sampling method and were investigated by the questionnaires on drug use knowledge and behavior. RESULTS: The residents' average awareness rate for 11 pieces of basic drug use information was 48.3% (32,750/67,749). The residents' average awareness rate in the rural (40.3%, 9189/22 792) was lower than that in metropolitan (51.9%, 11 483/22 110) and small and middle-sized cities (52.9%, 12,078/22,847) and the differences had statistical significance (χ2=889.30, P<0.01). Overall, 77.0% (4742/6159) of residents purchased drug according to the doctors' prescription; 36.9% (2271/6159) of residents bought by their experiences; 33.3% (2049/6159) of residents did not know whether they had bought faked drugs; 32.7% (2016/6159) of residents did not read instructions carefully before using drug; 83.4% (5134/6159) of residents stored drugs in their house and only 29.2% (1798/6159) of residents would check up expired drugs regularly; 59.6% (3673/6159) of residents changed drug by themselves after suspected adverse reaction of drugs. CONCLUSION: Chinese urban and rural residents' knowledge level of drug use is inadequate and drug use behaviors are not optimistic. Drug use health education should be enhanced among urban and rural residents.

[Status of knowledge and behaviors about chronic diseases prevention for Chinese residents in 2008].

OBJECTIVE: To learn the status of knowledge and behaviors about chronic diseases prevention for Chinese residents, and to provide basis for developing health education strategy. METHODS: Using multi-stage stratified random cluster sampling, 79 542 residents aged 15-69 years old from 31 provinces (municipalities and autonomous regions) and Xinjiang Production and Construction Corps in Mainland China were investigated with the questionnaire of chronic diseases prevention. RESULTS: There were 78 429 valid questionnaires recovered. The effective questionnaire return rate reached 98.60%. For some questions such as how to face second hand smoking, diseases types caused by second hand smoking, milk daily intake, drink daily intake for adult and the correct cognition to weight control, the correct rates were all below 30%. There were only 3.87% respondents possessed knowledge and behaviors about chronic diseases prevention. The proportion possessed knowledge and behavior about chronic diseases prevention of the urban population was higher than that of the rural population. The proportion of respondents aged from 35 to 45 was higher than that of other respondents. The higher were educational levels, the higher was the proportion. These differences had all statistical significance (P < 0.01). CONCLUSION: The proportion possessed knowledge and behavior about chronic diseases prevention of respondents was low, especially to some specific prevention measurement such as how to control salt daily intake. In future, different health education strategies about chronic diseases prevention should be developed for different population.