中国公众健康素养综合评价指标体系研究

目的 利用全国健康素养抽样调查数据,从调查问卷中进一步筛选指标,建立健康素养综合评价指标体系,为健康素养综合评价指数的制定奠定基础.方法 采用多阶分层方法对6省18～69岁居民进行抽样,通过健康素养全国调查问卷进行现场调查.问卷回收后将问卷中的答案按照错误、说不清(不一定)、正确3种答案分别赋值0,1,2分的规则进行重新赋分后计算指标的难易度和鉴别度,筛选出满足难易度和鉴别度要求的指标进入健康素养综合评价指标体系,并通过计算克朗巴赫α系数、相关分析、回归分析和聚类分析等方法进行指标体系的信、效度评价.结果 此次调查共抽取样本11 759人,回收有效问卷11 693份,有效回收率为99.4%,样本的玛叶指数为4.92.本研究共筛选出40个指标进入健康素养评价指标体系,指标体系信度达到0.847,指标体系与问卷总分相关系数为0.948,通过对样本进行聚类分析,各组间差异有统计学意义,指标体系中各维度的方差膨胀因子均小于5.结论本研究建立的健康素养综合评价指标体系具有良好的信度和效度,各维度间不存在共线性,该指标体系为健康素养综合评价指数的制定奠定了基础,是评估健康素养的有效工具.

Study on indicator system for evaluating the adult health literacy in China

Objective To establish a comprehensive evaluation indicator system for healthy literacy based on national survey data. Method A multi-stage stratified sampling method was carried out to select the sample population in six provinces of China,which were adults aged 18-69 years old. The national health literacy questionnaire was used to investigate the sample populations. The answers were scored according to the error answer of 0, uncertain answer of 1 and the correct answer of 2. The degrees of difficulty and difference were calculated and be used to screen the indicators from the questionnaire as to establishing the comprehensive evaluation indicator system of the health literacy. The Cronbach α coefficient, correlation analysis, regression analysis and cluster analysis methods were used to assess the reliability and validity of the indicator system. Results The samples were 11 759 people, the valid questionnaires were 11 693 and the effective recovery rate was 99.4% ,the Myer' index of sample was 4.92. There were 40 indexes selected to establish the comprehensive evaluation indicator system of health literacy. The correlation coefficient between indicator system and the questionnaire scores was 0.948 (P<0.01), there were the significant differences between groups of being clustered by Q cluster analysis method (P<0.01). The VIF of these four dimensions was less than 5. Conclusion In this study, the comprehensive evaluation indicator system had a good reliability and validity,and there existed no collinearity among four dimensions of indicator system, it should be the foundation for developing comprehensive evaluation index of health literacy.