School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110, Taiwan.
Center for General Education, Taipei Medical University, Taipei 110, Taiwan.
Health Promot Int. 2021 Mar 12;36(1):20-33. doi: 10.1093/heapro/daaa033.
The study was to develop the e-healthy diet literacy (e-HDL) questionnaire based on the comprehensive health literacy (HL) conceptual framework, to examine the association among HL, e-HDL, health behaviors and outcomes. A nationwide study was conducted on 1342 adults aged 18 years and above, between April and September 2017. Multi-stage random sampling was used to recruit the participants from four regions and 19 cities and counties in Taiwan. HL and e-HDL were measured by HLS-SF12 and the e-healthy diet literacy questionnaire (e-HDLQ), respectively. Socio-demographics, behaviors (e.g. smoking, drinking and exercising) and health outcomes were also measured. Principal component analysis (PCA), linear regression models and logistic regression models were used. The mean age was 33.9 ± 11.4 years. The e-HDLQ was constructed with 11 items. A positive association between HL and e-HDL was found. In the multivariate analysis, HL and e-HDL were significantly lower in men and higher in those who used Facebook for searching information. HL was positively associated with the ability to pay for medication, and social status. The e-HDL was lower in older participants, and people who searched for healthy cooking, healthy food places or weight control, as compared with ones searched for nutritional therapies, while positively associated with education. Both HL and e-HDL were positively associated with health status and physical activities. In conclusion, the valid e-HDL survey tool was developed for general public use. The e-HDL strongly associated with HL, while both were determined by gender, online searching means and linked to health behaviors and outcomes.
本研究旨在基于综合健康素养（HL）概念框架开发电子健康饮食素养（e-HDL）问卷，以检验 HL、e-HDL、健康行为和结果之间的关联。2017 年 4 月至 9 月期间，在台湾对 1342 名 18 岁及以上成年人进行了一项全国性研究。采用多阶段随机抽样法，从台湾四个地区和 19 个市县招募参与者。HL 和 e-HDL 分别通过 HLS-SF12 和电子健康饮食素养问卷（e-HDLQ）进行测量。还测量了社会人口统计学、行为（例如吸烟、饮酒和运动）和健康结果。采用主成分分析（PCA）、线性回归模型和逻辑回归模型。参与者的平均年龄为 33.9±11.4 岁。e-HDLQ 由 11 个项目构成。HL 和 e-HDL 之间存在正相关。在多变量分析中，男性的 HL 和 e-HDL 较低，而使用 Facebook 搜索信息的人则较高。HL 与支付药物费用的能力和社会地位呈正相关。年龄较大的参与者的 HL 和 e-HDL 较低，与搜索营养疗法相比，搜索健康烹饪、健康食品场所或体重控制的人则较低，而与教育呈正相关。HL 和 e-HDL 均与健康状况和体育活动呈正相关。总之，开发了适用于普通大众使用的有效的 e-HDL 调查工具。e-HDL 与 HL 密切相关，而这两者均由性别、在线搜索方式决定，并与健康行为和结果相关联。
