珠海市居民健康素养评价指标研究

目的探索中国公众健康素养评价指标。方法应用整群抽样方法在珠海市香洲、斗门和金湾3个行政区内分别抽取6个居委会和6条行政村15～69岁人群进行问卷调查，调查内容主要为人群基本情况（12项）、健康素养量表（20项）、自我健康评价量表（18项）3部分。应用Cronbach仅系数、折半信度对量表信度进行一致性检验，应用因子分析评价量表结构效度，并建立因子分析模型，提取模型公因子，分析各量表的维度，并对自我健康评价因子和健康素养因子进行Pearson相关分析。结果共调查3000人，实际回收有效问卷2823份，有效问卷率94．1％。健康素养量表Cronbach α系数、折半信度分别为0．886、0．789；抽样适度测定值（KMO）〉0．70，Battlett球型检验结果显示P〈0．01。健康素养因子模型包括健康知识、行为、技能和理念4个主要公因子成分，共解释原始变量54．56％的信息。自我健康评价量表Cronbach α系数、折半信度分别为0．852、0．729；KMO〉0．70，Battlett球型检验结果显示P〈0．01。自我健康评价因子模型包括身体状态、心理状态和社会适应状态3个主要公因子成分，共解释原始变量57．15％的信息。社会适应状态因子与健康知识、行为、技能和理念均呈正相关（P〈0．01）；身体状态因子与知识、技能和理念呈正相关关系（P〈0．01）；心理状态因子与行为和技能呈负相关关系，与理念呈正相关关系（P〈0．01）。结论初步建立珠海市居民健康素养量表及其评价指标体系，可从健康知识、行为、技能和理念4个主要方面评价居民素养水平。

Indexes for health literacy of residents in Zhuhal City

Objective To obtain indexes for health literacy of Chinese population. Methods By cluster sampling, residents aged 15 -69 years from 6 villages and 6 communities in Xiangzhou, Doumen, and Jinwan Districts of Zhuhai City were investigated with questionnaires containing general information （ 12 items）, health literacy scales （20 items） , and self-health evaluation scales （18 items）. For the scales, the reliability was measured by the Cronbach α and the split-half reliability coefficient, and the structural validity was assessed through factor analysis. With factor analysis models, we analyzed the scale dimensions and determined major common factors. The Pearson method was applied to evaluate the correlation of the common factors between the 2 types of scales. Results Of the questionnaires administered, 94. 1% （2 823/3 000） met the criteria for analysis. For health literacy scales, the Cronbach α and the split-half reliability coefficient were 0. 886 and 0. 789, respectively ; the Kaiser-Meyer-Olkin measure of sampling adequacy （KMO） was 〉0. 70, and the Bartlett＇s test of sphericity was significant （P 〈0. 01 ） ; the four major common factors were related to knowledge, behavior, skills, and ideas, respectively, which interpreted 54. 56% information of the original variables. For self-health evaluation scales, the Cronbaeh α and the split-half reliability coefficient were 0. 852 and 0. 729, respectively; KMO was 〉 0. 70, and the Barttlett＇s test of sphericity was significant （ P 〈 0.01 ） ; the 3 major common factors were related to physical health, psychological health, and social adaptation, respectively, which explained 57. 15% information of the original variables. Among the common factors, those about physical health and social adaption both were positively associated with those about health literacy （P 〈 0. 01 ）, except that the physical health factor wasn＇ t significantly related to the behavior factor; the psychological health factor was related positively with the ideas factor （ P 〈 0. 01 ） but negatively with the factors about behavior and skills （ P 〈 0.01 ）. Conclusion We obtained preliminary results on scales and indexes for health literacy of residents in Zhuhai City, and the health literacy can be evaluated mainly by knowledge, behavior, skills, and ideas.