Study On The Status Of Health Literacy And The Relationship With Health Behavior And Health Status Of Undergraduates In Two Provinces

Objectives This study was aimed to investigate the status and the influncing factors of undergraduates’ health literacy,and to analyze the relationship among health literacy,health-related behavior and health status of college students,as well as to explore the methods of improving the health literacy of undergraduates.Methods Stratified,multi-stage sampling,random and cluster method were used to select students from universities in Hebei and Jiangsu,and then they were investigated with questionnaire about health literacy.Three general colleges and universities of Hebei and Jiangsu Province were selected respectively from the"National List of Colleges and Universities",which was published by the Ministry of Education.These universities were stratified according to the liberal arts:science and medical majors.10 to 12 different liberal arts and science majors majors were selected respectively,while 6 different medical majors were selected,and 1 to 3 classes were randomly selected in the first and third grades of the selected majors,and all the students in the class were selected in the whole group.From October 2017 to March 2018,Chinese Residents Health Literacy Questionnaire(2017 edition)was used in Hebei Province and Jiangsu Province to investigate the students’health literacy.The self-made questionnaire was used to investigate the health behavior and health status of college students.SAS 9.4 was used to clean and analyze the data.Chi-square test and non-conditional logistic regression were used to find the influence factors of undergraduates’health literacy.The mediating effect was used in structural equation models in order to figure out the effect health-related behavior on the relationship between health literacy and health status.Results A total of 10.890 questionnaires were collected in this study,and 10298(94.6%)valid questionnaires were analyzed.4590(44.6%)students were from Hebei,and 5708(55.4%)students were from Jiangsu;3986(38.7%)were male and 6312(61.3%)were female;5319(51.7%)were freshman and 4979(48.3%)were junior;liberal arts students,science students and medical students accounted for 40.16%,40.19%.and 19.65%.respectively;the average age was 19.3 ± 1.3 years old.The health literacy level of undergraduates in two provinces was 37.2%,undergraduates’s health literacy leval was 37.8%in Jiangsu,and 36.6%in Hebei.36.8%of male and 37.6%of female had health leteracy,33.9%of freshman and 40.8%of junior had health literacy,the level of health literacy of liberal arts students,science students and medical students was 35.6%,33.7%and 47.8%,respectively.The health knowledge literacy level(46.2%)was higher than health skill literacy(44.9%)and health behavior literacy(40.3%).The public-oriented literacy level from high to low were scientific health concept(71.4%),safety and first aid(63.8%),chronic disease prevention(48.7%),health information(34.1%),infectious disease prevention(32.0%)and basic medical care(16.5%).The result of single-variate analysis showed that the health literacy level of junior was higher than that of freshman,the health literacy level of medical students was the highest.liberal arts students was higher than science students,compared with the father’s education level is illiterate and primary,those whose father’s education is in the junior high school and above level had better health literacy,those whose mother’s education is in the higher level had better health literacy;those whose father’s and mother’s occupation are corporate employee had the highest level of health literac;those who expense 500～1999 yuan per month had better health literacy,college students who with general and excellent self-report academic performance had better health literacy level,the differences were statistically significant(P<0.05).The results of logistic regression analysis showed that grade,major,parent’s education level,father’s occupation,monthly expense and selfreport academic performance had influence on college students’health literacy level.The characteristics distribution and influence of the three aspects of health literacy and six types of health problems literacy were basically consistent with the overall health literacy level.The proportion of undergraduates who with health literacy had good health habits,eating breakfast every day,eating out fewer times,no smoking,no drinking,exercising for 1 to 2 hours per day,spending less than 3-hour per day on Internet was lower than those who without health literacy,and the difference was statistically significant(P<0.05).Those who with health literacy had good self-reported health status and were not absent due to illness,the difference was statistically significant(P<0.05).Students with health literacy had higher rates of self-reported symptoms in the past 2 weeks,but they had lower rates of the current illness.the difference was statistically significant(P<0.05).Health-related behavior had mediating effect on the relationship between health literacy and health status.As the intermediate variable,health habits,diet,and online behavior contributed 27.0%,11.6%,and 3.3%of the total effect in the relationship between health literacy and self-reported health status,respectively.The mediating effects of Internet,smoking,and drinking in the relationship between healthy lifestyle and behavior literacy and self-reported health status were 5.3%,7.0%,and 3.5%,respectively.Exercise behavior has a mediating effect on the relationship between basic knowledge and conceptual literacy and self-reported symptoms,and the mediating effect accounted for 14.6%of the total effect.Health habits,diet,online,smoking,and drinking behaviors accounted for 13.9%.19.4%.5.6%,5.6%,and 5.6%of the total effects in healthy lifestyles and behavioral literacy and current diseases,respectively.Conclusion The health literacy level of college students is higher than chinese residents’.The health knowledge literacy level is the highest,while the healthy lifestyle and behavior literacy level is the lowest among three-dimension health literacy.Among the six types of health literacy,the levels of scientific health concept literacy and the safety and first aid literacy are higher,but the basic medical literacy level is the lowest,Grade,major,father’s education level,father’s occupation,monthly expenses,and self-reperted academic performance are the influencing factors of college students’health literacy.College students with healthy literacy have healthy lifestyle and good health status.Health literacy can affect health status indirectly by affecting health-related behavior.