| Objective:This study was to understand the status of health literacy,perception of risk and health behavior,and to clarify the differences in demographic characteristics of health literacy,perception of risk and health behavior,and analyze the correlation between health literacy,perception of risk and health behavior,as well as to explore the path and intensity of health literacy and perception of risk are effected on health behavior among peoples with high-risk of chronic disease,so as to provide a reference for improving the health behavior and health status of them.Methods:We used a cross-sectional survey which conducted from June to August 2018 with 287 participants who have high-risk of chronic diseases.The participants selected by convenient sampling and all of them had a free physical examination in community health service center in Yanji.A total of 300 questionnaires was finished done by the participants and 287(95.67%)questionnaires valid.The questionnaire includes demographic characteristics,health literacy scale,medical perception of risk scale and self-rated abilities for health practice scale(SRAHP).SPSS 19.0 and AMOS24.0 software was used to analyze the data.Results:(1)Characteristics of participantsWe had investigated 287 participants who have high-risk of chronic disease in this study.The number of men and women in participants was 49.5%and 50.5%,and the number of Han Chinese and the other ethnic minorities was more than Korean Chinese(76.3%and 23.7%).There were 245(85.3%)participants was married,and 216(75.3%)participants was living with their partner.107(37.3%)participants were graduated senior/vocational/technical secondary schools,and 108(37.6%)participants were retired.83(28.9%)participants had an income of 2000 to 3000 RMB per month.150(52.3%)participants had basic medical insurance of resident in town.172(60.0%)participants had no experience of visit hospital in last 6 months,and 99(34.5%)participants spent less than 100 yuan on medical care.42(14.6%)participants had a family genetic history of chronic diseases,and 127(44.3%)participants felt healthy.(2)Health literacy level of peoples with high-risk of chronic diseaseThe health literacy level of participants was 90.63±12.664.The mean scores of four sub-scales were as follows:information acquisition ability was 3.88±0.642,communication and interaction ability were 3.80±0.868,willingness to support was 3.71±0.577,and willingness to improve health 3.68±0.775.There were statistically significant differences in marital status,living status,educational level,occupation and income level among participants(P<0.05)(3)Perception of risk level of peoples with high-risk of chronic diseaseThe medical perception of risk level of participants was 36.83±9.704.The mean scores of the three sub-scales were as follows:economic risk was 3.17±1.002,physical diagnosis and treatment risk was 3.16±0.954,and psychosocial risk was 2.79±0.918.There were statistically significant differences in gender,nationality,occupation,income level and self-reported health status on medical perception of risk of chronic diseases among participants(P<0.05).(4)Health behavior level of peoples with high-risk of chronic diseaseThe health behavior level of participants was 61.00±20.280.The mean scores of four sub-scales were as follows:health responsibility was16.4±5.724,nutrition was 16.09±5.241,psychological comfort was 15.44±6.620 and exercise was 13.07±6.763.There were 67(23.3%)participants with a high level of healthy behavior.There were statistically significant differences in living conditions,occupation,income level,frequency of medical treatment in the last 6 months and self-reported health status in health behavior among participants(P<0.05)(5)The correlation between health literacy,perception of risk and health behaviorPearson correlation analysis showed that there was a negative correlation between health literacy and perception of risk(P<0.05),and the range of correlation scores between the sub-scales and total scale of two variables was from 0.382 to-0.152.There was a negative correlation between perception of risk and health behavior in high-risk group of chronic diseases(P<0.05),and the range of correlation score between the sub-scales and total scale of two variables were from-0.376 to-0.175 There was a positive correlation between health literacy and health behavior(P<0.01),and the range of correlation score between the sub-scales and total scale of two variables were from 0.234 to 0.485(6)Effects of health literacy and perception of risk on health behavior in peoples with high-risk of chronic diseaseStructural equation model shows that perception of risk plays an intermediary role between health literacy and health behavior.The health literacy has a direct effect 0.392 and indirect effect 0.111 on health behavior.The health literacy effected on perception of risk(β=-0.319),the perception of risk also effected on health behavior(β=-0.348),and health literacy totally effected on health behavior(β=0.503)Conclusions:(1)The overall level of health literacy of people with high-risk of chronic diseases was low,and the proportion of participants have healthy literacy was 30.70%.Furthermore,the participants who are married,living with partner,educated in college education or above,monthly income more than 5,000 yuan had higher level of health literacy.(2)The perception of risk was medium level,and the proportion of participants with high perception of risk level was 47.70%.Moreover,the peoples who were Women,Han Chinese and other ethnic minorities,laid-off workers or unemployment,monthly income of 1,000～2,000 yuan and self-reported was unhealthy have the highest level of perception of risk.(3)The level of health behavior of participants was low.The proportion of participants with high level of health behavior was 23.30%.In addition,those who lived with their children or other relatives,retirees,monthly income was more than 5000 yuan,medical treatment three or more times in the last 6 months and those who were self-reported was healthy had the higher scores on health behavior.(4)Results indicate that there is a negative correlation between health literacy and perception of risk,and the relationship between perception of risk and health behavior was negative,and there was a positive correlation between health literacy and perception of risk.Moreover,the health literacy has both direct and indirect effect on health behavior among peoples with high-risk of chronic diseases,and perception of risk which was partly mediated between them. |
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