Jin Shengxuan, Fa Ruobing, Chao Jianqian, Zhang Na, Bao Min, Wu Yanqian, Wang Leixia, Tan Gangrui
Health Management Research Center, School of public health, Southeast University, NO. 87, Dingjiaqiao Road, Gulou District, Nanjing, 210009, Jiangsu, China.
School of Public Health Management, Jiangsu Health Vocational College, Nanjing, 211166, Jiangsu, China.
BMC Public Health. 2025 Jun 10;25(1):2149. doi: 10.1186/s12889-025-23394-9.
The health literacy among older adults deserves further investigation. This study aimed to conduct a multistage research to investigate the current status and key determinants of health literacy among Chinese older adults and evaluate the effectiveness of an active learning intervention in enhancing their health literacy.
In the first phase, a cross-sectional study surveyed 608 elderly residents. The second phase was a two-arm parallel randomized controlled trial (RCT) in which 120 older adults were randomly assigned to a three-month intervention (n = 60) or control group (n = 60). The active learning program intervention included health lectures, active discussions, heuristic questioning, and family homework, while the control group only received health literacy pamphlets. Health literacy scores were the primary outcome and were evaluated from five dimensions. The RCT data was collected at baseline and the completion of the intervention.
In the cross-sectional study, the median (IQR) health literacy score was 4.355 (4.030, 4.647) (range: 0-5) Quantile regression showed that sex, education, number of children, self-reported health, chronic disease and insurance significantly affected health literacy. The intervention group showed significant improvement in all dimensions (P < 0.05), with significant group × time interactions in health knowledge, health behaviours, health skills, health intentions and total health literacy. Multiple linear regression indicated that marriage status related to health knowledge, education level related to health behaviours and total health literacy, chronic diseases and insurance factors related to health skills, and sex and insurance factors related to health intentions have significant effects.
The health literacy of older adults is influenced by individuals, families, and societal factors. The active learning program effectively enhances comprehensive health literacy and is a valuable strategy for advancing China's proactive health strategy by mobilizing the roles of the individual, family, and society.
The trial has been retrospectively registered on April 8, 2025, at the Chinese Clinical Trial Registry (ChiCTR2500100396|| http://www.chictr.org.cn/ ), which is a primary registry of the International Clinical Trial Registry Platform of the World Health Organization.
老年人的健康素养值得进一步研究。本研究旨在开展多阶段研究，以调查中国老年人健康素养的现状和关键决定因素，并评估主动学习干预对提高其健康素养的有效性。
第一阶段为横断面研究，对608名老年居民进行了调查。第二阶段是双臂平行随机对照试验（RCT），将120名老年人随机分为为期三个月的干预组（n = 60）或对照组（n = 60）。主动学习项目干预包括健康讲座、积极讨论、启发式提问和家庭作业，而对照组仅收到健康素养宣传册。健康素养得分是主要结果，从五个维度进行评估。RCT数据在基线和干预结束时收集。
在横断面研究中，健康素养得分的中位数（IQR）为4.355（4.030，4.647）（范围：0 - 5）。分位数回归显示，性别、教育程度、子女数量、自我报告的健康状况、慢性病和保险显著影响健康素养。干预组在所有维度上均有显著改善（P < 0.05），在健康知识、健康行为、健康技能、健康意图和总体健康素养方面存在显著的组×时间交互作用。多元线性回归表明，婚姻状况与健康知识相关，教育水平与健康行为和总体健康素养相关，慢性病和保险因素与健康技能相关，性别和保险因素与健康意图相关，均有显著影响。
老年人的健康素养受到个人、家庭和社会因素的影响。主动学习项目有效地提高了综合健康素养，是通过调动个人、家庭和社会的作用推进中国积极健康战略的一项有价值的策略。
该试验已于2025年4月8日在中国临床试验注册中心（ChiCTR2500100396|| http://www.chictr.org.cn/ ）进行回顾性注册，该中心是世界卫生组织国际临床试验注册平台的一级注册机构。
