中国居民传染病健康素养量表编制与信效度检验

目的 初步编制中国居民传染病健康素养量表，评价其信度和效度。方法 根据世界卫生组织健康素养的定义确定量表的理论结构，采用探索性因子分析、主成分分析和信度及效度检验方法对2013年9-12月在浙江省嘉兴市、湖北省宜昌市和甘肃省兰州市抽取的8 858名城乡居民的传染病健康素养情况进行了分析，验证该量表的合理性。结果 通过探索性因子分析和主成分分析，确定中国居民传染病健康素养量表由2部分共28个条目组成；第1部分包括传染病的基本知识与观念（5个条目）、传染病的预防（7个条目）、传染病管理与治疗（4个条目）、对病原体和传染源的辨认（4个条目）、传染病的传播（2个条目）共22个条目，累积方差贡献率为46.273%；通过理论分析，将传染病传播维度的2个条目归入传染病的基本知识与观念维度，最终量表第1部分由传染病的基本知识与观念（7个条目）、传染病的预防（7个条目）、传染病管理与治疗（4个条目）、对病原体和传染源的辨认（4个条目）4个维度组成，4个维度的Cronbach's α系数分别为0.652、0.672、0.599、0.632，校正题项-总相关系数（CITC）分别为0.620、0.715、0.523、0.587，22个题项的难度系数为1.19~4.08，此部分量表具有较好的信度；量表第1部分中各条目的内容效度（CVI）指数均≥0.8，此部分量表的内容效度较好；不同性别、年龄、文化程度、婚姻状况、职业、健康状况、2周患病情况、日均上网时间、获取信息常用方式的居民第1部分总分差异均有统计学意义（均P<0.001），此部分量表具有较好的区分效度；量表第2部分用于测量个体对健康信息的认知能力，包括阅读理解及简单计算共4个条目，各条目答对组的平均分分别为（24.67±6.82）、（25.05±6.56）、（23.30±7.23）和（24.32±6.74）分，均高于答错组的（20.17±8.12）、（20.95±8.09）、（17.07±8.59）、（18.28±8.29）分（均P<0.001），此部分量表具有较好的区分效度。结论 初步编制的中国居民传染病健康素养量表具有较好的信度和效度，可作为中国居民传染病健康素养的测量和传染病干预效果评价的简易工具。

Development and evaluation of an infectious disease-specific health literacy scale

Objective To develop a scale for assessing infectious disease-specific health literacy (IDSHL) among Chinese residents and to evaluate reliability and validity of the scale.Methods Based on the definition of health literacy defined by World Health Organization,the conceptual construction of the scale was built.Exploratory factor analysis (EFA),principal component analysis (PCA) and reliability and validity test were used to assess psychometric properties of the scale.Totally 8 858 adult residents were sampled from Jiaxing city of Zhejiang province,Yichang city of Hubei province and Lanzhou city of Gansu province to test the appropriateness of the scale between September and December,2013.Results A scale with 28 items in 2 parts was constructed based on the results of EFA and PCA.For the scale finally established,the four dimensions (22 items) in the subscale A are knowledge and concept (7 items),disease prevention (7),disease management and treatment (4),and cognition on pathogen and source of infection (4),and the accumulated variance contribution of the 4 dimensions was 46.273%;the Cronbach's α values of the four dimensions were 0.652,0.672,0.599,and 0.632 and the corrected item-total correlation (CITC) of the 4 dimensions were 0.620,0.715,0.523,and 0.587,respectively.The difficulty coefficients of the 22 items ranged from 1.19 to 4.08,suggesting a good reliability of the subscale A;the content validity indexes were ≥0.8 for all the 22 items in the subscale A,demonstrating a good content validity.There were statistically significant differences in the total score of the IDSHL scale among the residents with different socio-economic characteristics,including gender,age,education level,marital status,occupation,health status,2-week morbidity,average time of daily internet browsing,and the way of information acquisition (P<0.001 for all),indicating a good discriminate validity of the subscale.The subscale B,consisting of 4 items for cognition on individualized health information,showed a good discriminate validity,with significantly higher average scores of 24.67±6.82,25.05±6.56,23.30±7.23,and 24.32±6.74 among the residents answering 4 items correctly than those of 20.17±8.12,20.95±8.09,17.07±8.59,and 18.28±8.29 among the residents having no correct answers to the 4 times,respectively (all P<0.001).Conclusion The established 28-item IDSHL scale is of good reliability and validity and could be used as a simple instrument for measuring infectious disease-specific health literacy and efficacy of intervention on infectious disease among Chinese residents.