| ObjectiveThis study uses Rasch model to evaluate the quality of health-cultural-literacy questionnaire of TCM(HCLQ-TCM),evaluate the quality of the questionnaire from the aspects of unidimensionality,information function,difficulty of the questionnaire,determine the knowledge gap of health-cultural-literacy of TCM(HCL-TCM)among people with different educational levels,analyze the influencing factors of HCL-TCM,explore the relationship between personal interest,perceived efficacy and behavior involvement and HCL-TCM and various dimensions of literacy scores,and further determine the knowledge gap of HCLTCM and each Regulators of Dimensional Literacy Knowledge Gap.MethodsThe data used for the quality assessment of the questionnaires are from the 2017 survey of Chinese citizens' HCL-TCM.Stratified multi-stage combined with random sampling methods were used in 328 survey points in 30 provinces(autonomous regions and municipalities)across the country.For the survey method,a questionnaire survey was conducted using HCLQ-TCM,A total of 89,107 people completed the survey,and 87,287 actual valid questionnaires.Questionnaires were used to assess the quality of 37 assessment questions of HCLTCM.After processing the raw data with SPSS 22.0,the data was imported into Winsteps 3.72.3 software for analysis,The questionnaire was comprehensively evaluated by indicators and items such as one-dimensionality test,data fitting test,white chart,bubble chart and other indicators.The data used by the Institute of Regulatory Factors of Knowledge Gap of HCL-TCM are from the 2018 survey of Chinese Citizens' HCL-TCM,which also uses a stratified multi-stage and random sampling method.The survey objects are distributed in 30 provinces(autonomous regions and municipalities)across the country.A total of 80,789 surveys were completed at 328 survey sites.After cleaning,78,342 study subjects were finally included.The information used in this research includes the general demographic data of the survey objects,the survey results of the popularization of health culture knowledge of TCM,and the survey results of HCL-TCM.SAS V9.4(SAS Institute)statistical analysis software was used to complete variable centralization and statistical analysis.Because the continuous variables do not obey the normal distribution,Wilcoxon test or Kruskal-Wallis H test was used to analyze the population differences in HCL-TCM.Kendall's tau-b correlation analysis was used to determine the correlation and significance of personal interest,perceived efficacy,and behavior involvement with HCL-TCM.Using the moderating effect model,the HCL-TCM and the dimensional literacy scores were used as dependent variables.Gender,age,urban and rural,income,self-assessed health,and media use were used as control variables(model 1)and education level(model 2).Personal interest,perceived efficacy,behavior involvement(model 3)as independent variables,cultural level*personal interest,cultural level*perceived effectiveness,cultural level*behavior involvement(model 4)as interaction variables,multi-level Regression analysis,and draw a regulating action chart based on standardized regression coefficients to express the trend of the relationship between the independent variable and the dependent variable as the regulating variable changes.Results(1)The questionnaire has a good one-dimensionality.The standard residual comparison chart after the principal component test shows that about 95%of the questions have a correlation value between-0.4 and 0.4,indicating that only the measurement was made.One nature,and no other test variables that affect the respondents.Second,the reliability of this questionnaire is high.It can be seen from the information function that the amount of information in the items is high.The values of all items Infit MNSQ and Outfit MNSQ are between 0.64-1.36,which can distinguish the differences more accurately.Ability of the subject.Third,according to White Turk,the difficulty of the questionnaire is close to the ability level of the participants,the difference is 21ogit,and the questionnaire is relatively simple,and the difficulty is moderate to lower.(2)The total score of HCL-TCM is(56.43±22.18)points,which is low.The results of analysis of variance showed that there were statistically significant differences in HCL-TCM among groups with different educational levels(H=3704.476,P<0.001),with the highest score for masters and above,at(73.92±17.08)points,without literacy The literacy score of the least literate population was the lowest(38.3±22.8).After controlling urban and rural,gender,age,health status,media use and other factors,the education level(?=0.292,P<0.001)was the most important influencing factor of HCL-TCM.The higher the level of education,the higher the score of HCL-TCM and the five dimensions of HCL-TCM,that is,the significant gap between HCLTCM and the five dimensions of HCL-TCM.(3)Urban and rural areas,gender,age,and income also affect the score of HCL-TCM.Multivariate analysis showed that urban residents(?=0.039,P<0.001),females(?=0.046,P<0.001),older people(?=0.104.P<0.001).and higher incomes(?=0.008,P<0.05),the better the self-assessed health status(?=0.031,P<0.001),the higher the score of HCLTCM.(4)Pearson correlation analysis showed that personal interest(r=0.401,P<0.01),perceived efficacy(r=0.398,P<0.01),behavior involvement(r=0.370,P<0.01),and HCL-TCM develops a positive correlation.After controlling factors such as urban and rural areas,gender,age,education,health status,and media use,multiple-level regression showed that personal interest(?=0.072,P<0.001),perceived efficacy(?=0.184,P<0.001),The degree of behavior involvement(p=0.184,P<0.001)had a positive predictive effect on t HCL-TCM,and had a positive predictive effect on the five-dimensional literacy.(5)There is an interaction between personal interest,behavioral involvement,and educational level,which can regulate the knowledge gap of HCL-TCM based on educational level.When personal interest(?=-0.015,P<0.001)And behavior involvement(p=-0.061,P<0.001)is higher,you can acquire more knowledge about traditional Chinese medicine health culture,thus narrowing the knowledge gap caused by education level.In the five-dimensional literacy,behavioral involvement can narrow the knowledge gap of HCL-TCM in each dimension.Conclusions(1)HCLQ-TCM is of high quality and can distinguish the ability theory and the difficulty of the questionees.The questionnaire is relatively simple as a whole.(2)The knowledge gap and the five-dimensional literacy knowledge gap of HCLTCM significantly exist.The gap in health literacy should be based on sufficient attention.(3)area,gender,age,income,and self-assessed health are the "fixed"influencing factors of HCL-TCM,and key populations should be targeted to popularize TCM health culture.(4)The higher the degree of personal interest,perceived efficacy,and behavior involvement,the higher the score of HCL-TCM.(5)Personal interest and behavior involvement can reduce the knowledge gap of HCL-TCM,and the improvement of personal interest and behavior involvement can enable people with lower education levels to acquire more knowledge about health culture of TCM.By reducing the knowledge gap,the less educated people can get rid of the constraints of social structural factors and improve the status of health inequality. |
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