| Objective:Improving the health literacy of residents is an important connotation for the Healthy China construction.Qingyunpu District of Nanchang has formed two types of communities with distinctive subcultural characteristics:corporate type and ordinary type due to historical reasons.This study intends to explore the effect of long-term standardized health literacy intervention services to generally examine the impact of long-term standardized health literacy service interventions on the health literacy level of residents under the background of subcultural factors.Our results could provide a basis for relevant government departments to carry out targeted residents’health literacy interventions.Methods:482 community residents aged 15-69 in Qingyunpu District,Nanchang City,Jiangxi Province were randomly selected in 2018 through sampling-simple random sampling-KISH table method,which including 241community residents of ordinary and 241 corporate subculture groups.The national health literacy monitoring questionnaire was used to conduct a baseline survey of residents’health literacy.After two-year service intervention in accordance with the national standardized community health literacy service plan,the same sampling method was adopted to randomly select two groups of people to conduct a post-intervention health literacy questionnaire survey,with 240 cases in each group in2020.The overall health literacy and literacy levels of the two groups before and after the intervention were evaluated according to a unified scoring standard.T-test and?2-test were used to compare the changes in the health literacy of the two groups before and after intervention.Double difference method was used to evaluate the two types of subcultural groups.Results:(1)There was no significant difference between the general cultural group and the corporate subculture group in terms of gender,age,ethnicity,education level and other basic characteristics before and after the intervention(all P>0.05).(2)The effect of community residents’health literacy intervention in the ordinary subculture group.(1)The correct answer rate of residents in 17 problems was significantly higher after the intervention(all P<0.05)over 50 health literacy problems.(2)While the residents’health literacy was divided into 6 dimensions,the results of health literacy availability before and after the intervention were:scientific health view 48.96%vs 54.58%,infectious disease prevention and control 18.26%vs35.00%,chronic disease prevention and treatment 21.16%vs 30.00%,safety and first aid 51.87%vs 64.58%,basic medical care 12.86%vs 20.00%,health information35.68%vs 44.58%.There is no statistical difference in the availability of scientific health concept before and after intervention(?~2=1.521,P=0.217)while the availability rate of other 5 dimensions was significantly higher after intervention(all P<0.05).The results of health literacy score before and after intervention was:scientific health view 7.1±2.65 vs 7.8±2.50,infectious disease prevention 4.1±1.61 vs4.7±1.72,chronic disease prevention 7.1±2.60 vs 7.7±2.93,safety and first aid9.9±3.18 vs 10.8±3.12,basic medical care 7.4±2.71 vs 8.1±2.80 points.There was no statistical difference the other 5 dimensions(all P<0.05)except health information scores before and after intervention(t=1.666,P=0.096).(3)While the residents’health literacy was divided into three dimensions,the results of the health literacy possession rate before and after the intervention were:basic knowledge and concepts38.17%vs 42.92%,healthy lifestyle and behavior 14.11%vs 27.92%,health skills16.60%vs 20.83%.There was no significant difference in the rate of the other two dimensions of health literacy before and after the intervention(both P>0.05)except life style and behavior(P<0.05).The results of health literacy score before and after intervention were:basic knowledge and concepts 18.6±5.46 vs 19.8±5.19,healthy lifestyle and behavior 12.3±4.69 vs 14.2±4.72,health skills 9.5±3.09 vs 10.0±3.10.The other two dimensions of health literacy scores were significantly higher after the intervention(both P<0.05)except health skills score(t=1.958,P=0.051).(4)The overall health literacy possession rate of residents after intervention(25.00%)was significantly higher than before(17.01%)(?~2=4.625,P=0.032).The overall health literacy score after intervention(44.0±11.81)was significantly higher than before(40.3±11.96)(t=3.378,P=0.001).(3)The effect of community residents’health literacy intervention in the enterprise-type subculture group.(1)The correct answer rate of residents in 17problems was significantly higher after the intervention(all P<0.05)over 50 health literacy problems.(2)While the residents’health literacy was divided into 6dimensions,the results of health literacy availability before and after the intervention were:scientific health concept 61.00%vs 62.08%,infectious disease prevention and control 21.58%vs 34.17%,chronic disease prevention and treatment 28.63%vs40.83%,safety and first aid 62.24%vs 72.50%,basic medical care 20.33%vs29.17%,health information 43.98%vs 55.83%.There is no statistical difference in the availability of scientific health concept before and after intervention(?~2=0.060,P=0.806)while the availability rate of other 5 dimensions was significantly higher after intervention(all P<0.05).The results of health literacy score before and after intervention was:scientific health concept 7.9±2.50 vs 8.0±2.50,infectious disease prevention and control 4.3±1.65 vs 4.7±1.77,chronic disease prevention and treatment 7.6±2.67 vs 8.5±2.54,safety and first aid 10.5±2.83 vs 11.4±2.73,basic medical care 7.9±2.86 vs 8.7±2.62,health information 5.0±2.03 vs 5.6±1.98.There was no statistical difference the other 5 dimensions(all P<0.05)except scientific health concept before and after intervention(t=0.637,P=0.524).(3)While the residents’health literacy was divided into three dimensions,the results of the health literacy possession rate before and after the intervention were:basic knowledge and concepts 42.74%vs 51.67%,healthy lifestyle and behavior 18.26%vs 38.75%,health skills 31.95%vs 38.75%.There were significant difference in the rate of the other two dimensions of health literacy before and after the intervention(both P<0.05)except health skills(?~2=2.433,P=0.119).The results of health literacy score before and after intervention were:basic knowledge and concepts 19.8±4.74 vs 20.3±4.69,healthy lifestyle and behavior 12.9±4.79 vs 15.2±4.66,health skills 10.4±3.24 vs11.3±3.11.The other two dimensions of health literacy scores were significantly higher after the intervention(both P<0.05)except health skills score(t=1.258,P=0.209).(4)The overall health literacy possession rate of residents after intervention(41.67%)was significantly higher than before(24.07%)(?~2=16.887,P=0.001).The overall health literacy score after intervention(46.8±11.31)was significantly higher than before(43.1±11.27)(t=3.558,P<0.001).(4)The analysis of the health literacy intervention in the general subculture group residents and the enterprise subculture group residents found that:(1)While the residents’health literacy was divided into 6 dimensions,our results shows a better intervention effect in the general subculture group than corporate subculture group over all six dimensions:scientific health concept(model:adjusted R~2=0.708,P<0.001;DID:β=-7.617,P<0.001),prevention and treatment of infectious diseases(model:adjusted R~2=0.686,P<0.001;DID:β=-4.270,P<0.001),prevention and treatment of chronic diseases(model:adjusted R~2=0.704,P<0.001);DID:β=-6.831,P<0.001),safety and first aid(model:adjusted R~2=0.725,P<0.001;DID:β=-9.906,P<0.001),basic medical care(model:adjusted R~2=0.705,P<0.001;DID:β=-7.296,P<0.001),health information(model:adjusted R~2=0.682,P<0.001;DID:β=-4.417,P<0.001).(2)While the residents’health literacy was divided into three dimensions,our results shows a better intervention effect in the general subculture group than corporate subculture group over all 3 dimensions:basic knowledge and concepts(model:adjusted R~2=0.727,P<0.001;DID:β=-19.259,P<0.001),healthy lifestyle and behavior(model:Adjusted R~2=0.713,P<0.001;DID:β=-11.959,P<0.001),health skills(model:adjusted R~2=0.722,P<0.001;DID:β=-9.119,P<0.001).(3)The double difference of residents’overall health literacy found that the intervention effect in the general subculture group was better than that of the enterprise subculture group(model:adjusted R~2=0.733,P<0.001;DID:β=-40.337,P<0.001).Conclusion:The national standardized community health literacy service plan is adopted to intervene the health literacy of community residents.After the intervention,the health literacy of residents has been significantly improved,and the community health literacy service plan is feasible.The intervention effect of the ordinary subcultural group is better than that of the corporate subcultural group,suggesting that it is necessary to implement different health literacy interventions for people with different subcultural backgrounds.Differentiated intervention strategies can contribute to the health literacy level of community residents and promote Health China Construction.Specific plans for the health literacy intervention of people in different subcultural communities require useful exploration by government departments and researchers. |
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