| Objective: To understand the environmental and health literacy of medical students,and explore the factors that influencing the medical students’ environmental and health literacy level in Gansu Province.It provides reference for targeted environmental and health education,and also provides baseline data for future research on environmental and health literacy.Methods: 6,740 medical students from 9 medical universities in Gansu Province were selected by stratified cluster random sampling from October to December 2018.The questionnaire was designed based on the "Core Test Questions of Civil Environmental and Health Literacy" in "Technical Guide for Citizen Environmental and Health Literacy Assessment(Trial)" issued by the Ministry of Ecology and Environment of the People’s Republic of China in June 2017.The content includes three parts: the informed consent form,the basic information of the respondents,and the main content of the environmental and health literacy questionnaire.Excel 2016 was used for data entry and database construction.SPSS22.0 was adopt to make a descriptive analysis of the demographic characteristics,scores of environmental and health literacy and classification literacy,correct recognition of questionnaire questions,and the availability of environmental and health literacy.Pearson correlation analysis was used for correlation analysis of different literacy.Chi-square test was used for difference test in the attainment of environmental and health literacy and classification literacy among different demographic characteristics.Binary multi-factor Logistic regression analysis was used to analyze the influencing factors of environmental and health literacy.Results: A total of 6740 questionnaires were distributed in 9 universities in Gansu Province,and 6733 questionnaires were recovered.The recovery rate was99.9%.After removing questionnaires with bias and missing data,6619 questionnaires were obtained.Among the medical students surveyed,375 hadenvironmental and health literacy,accounting for 5.7% of the total.The number of student with first-level classification literacy in the three aspects of basic ideas,basic knowledge and basic skills were 940(14.2%),119(1.8%),and 2671(40.4%),the most had the basic skills and the least had the basic knowledge;The number of people with basic cognition,basic attitude,scientific knowledge,behavioral knowledge,cognitive skills,and operational skills in the six categories of secondary classification literacy were 834(12.6%),1827(27.6%),and 86(1.3%),1178(17.8%),5553(83.9%),1867(28.2%),the number of students with cognitive skills was the highest,while the number of people with scientific knowledge was the least.The five questions with low correct cognition are all related to the environmental and health scientific knowledge.The positive answer rate were all less than 15%,and two of them have a positive answer rate less than 5%.There was a positive correlation between the scores of three classification literacy respectively,with P values all less than 0.01.The results of univariate analysis showed that the differences in overall levels of different professional levels,gender,ethnicity,birthplace,grade,professional environmental and health literacy were statistically significant(all P<0.05).Multi-factor logistic regression analysis results showed that gender,professional level,nationality,grade,and major all were factors influencing the overall level of environmental and health literacy.Among them,the availability of female students was lower than that of male students(OR=0.601).The possession rate in technical secondary students is lower than undergraduate students(OR=0.102).The medical students of ethnic minorities were lower than the Han nationality medical students(OR=0.511).Compared with first-year medical students,the availability rate of second-year and third-year medical students were higher(OR=1.842,2.404).Compared with clinical medicine majors,the availability rate of medical students in preventive medicine majors were higher(OR=1.871).Conclusions: 1.The overall level of environmental and health literacy of medical students in Gansu Province was low.Among them,the level of basic knowledge literacy lack was the main reason leading to the low level of environmental and health literacy;2.The education of environmental and health scientific and behavioral knowledge for medical students in Gansu Province needs to be strengthened;3.There was a positive correlation between basic ideas,basic knowledge,and basic skills,indicating that in order to improve the overall level of literacy,we must focus on these three aspects together;4.The environmental and health literacy level of medicalstudents in Gansu Province was affected by many factors.The literacy level of female students,ethnic minorities,lower grades,low education background and non-preventive medical students is low,and targeted measures should be taken to improve their literacy. |
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