Chen Xuewei, Li Ming, Kreps Gary L
School of Community Health Sciences, Counseling and Counseling Psychology, College of Education and Human Sciences, Oklahoma State University, 429 Willard Hall, Stillwater, OK, 74078, USA.
Department of Health Sciences, College of Health Professions, Towson University, Towson, MD, USA.
J Racial Ethn Health Disparities. 2022 Apr;9(2):489-497. doi: 10.1007/s40615-021-00979-9. Epub 2021 Feb 9.
Acculturation is an important factor that is uniquely associated with health literacy among racial/ethnic minorities. We examined the relationship between acculturation and health literacy among Chinese speakers in the USA who have limited English proficiency. Since language proficiency is an important subcomponent of acculturation, we also explored the relationship between English language proficiency and health literacy.
Our sample included 405 participants. To evaluate the appropriateness of the acculturation instrument to elicit valid data, we performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We performed linear regressions to investigate the relationship between acculturation and health literacy.
Our acculturation instrument can be divided into three factors: English language proficiency, interactions with family and friends, and interactions with neighbors. The acculturation measurement model exhibited good fit. Higher US acculturation was associated with lower Chinese information appraisal, higher English functional health literacy, and higher English information appraisal. Higher English language proficiency was positively associated with English functional health literacy and English information appraisal. There was no relationship between English language proficiency and Chinese health literacy. Neither acculturation nor English language proficiency was associated with empowerment.
English language proficiency might play an important role in English functional health literacy and information appraisal. Developing and implementing English as a second language (ESL) curriculum in health promotion intervention programs can effectively improve English functional health literacy and information appraisal among populations with LEP.
文化适应是一个与少数种族/族裔群体健康素养独特相关的重要因素。我们研究了美国英语水平有限的华语使用者的文化适应与健康素养之间的关系。由于语言能力是文化适应的一个重要子成分，我们还探讨了英语语言能力与健康素养之间的关系。
我们的样本包括405名参与者。为了评估文化适应工具获取有效数据的适用性，我们进行了探索性因素分析（EFA）和验证性因素分析（CFA）。我们进行线性回归以研究文化适应与健康素养之间的关系。
我们的文化适应工具可分为三个因素：英语语言能力、与家人和朋友的互动以及与邻居的互动。文化适应测量模型显示出良好的拟合度。较高的美国文化适应程度与较低的中文信息评估、较高的英语功能健康素养和较高的英语信息评估相关。较高的英语语言能力与英语功能健康素养和英语信息评估呈正相关。英语语言能力与中文健康素养之间没有关系。文化适应和英语语言能力均与赋权无关。
英语语言能力可能在英语功能健康素养和信息评估中发挥重要作用。在健康促进干预项目中开发并实施英语作为第二语言（ESL）课程，可以有效提高英语水平有限人群的英语功能健康素养和信息评估能力。
