Department of Social Medicine and Health Education, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, PR China.
BMC Public Health. 2013 Mar 22;13:261. doi: 10.1186/1471-2458-13-261.
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.
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.
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 (β = 0.324) and health literacy (β = 0.346). Health literacy is also affected by prior knowledge (β = 0.245) and age (β = -0.361). Health literacy is a direct influencing factor of health behavior (β = 0.101). The most important factor of health status is age (β = 0.107). Health behavior and health status have a positive interaction effect.
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.
健康素养已被定义为个体获取、处理和理解基本健康信息和服务以做出适当健康决策的能力程度。目前，很少有研究通过使用统计建模来验证健康素养决定因素的因果途径。本研究的目的是开发和验证一个个体层面的健康素养模型，该模型能够最好地解释健康素养的决定因素以及健康素养与健康行为甚至健康状况之间的关系。
对 3222 名中国成年居民进行了基于技能的健康素养测试和自填式问卷调查。采用路径分析对模型进行验证。
该模型解释了 38.6%的健康素养变异、11.7%的健康行为变异和 2.3%的健康状况变异：（GFI = 0.9990；RMR = 0.0521；χ² = 10.2151，P = 0.1159）。教育对先验知识（β = 0.324）和健康素养（β = 0.346）有正向直接影响。健康素养还受到先验知识（β = 0.245）和年龄（β = -0.361）的影响。健康素养是健康行为的直接影响因素（β = 0.101）。健康状况的最重要因素是年龄（β = 0.107）。健康行为和健康状况之间存在积极的交互作用。
该模型很好地解释了健康素养的决定因素以及健康素养与健康行为之间的关系。它可以用于制定干预策略来提高个体健康素养，进而促进健康行为和健康状况。
