D > KMO = % R51 A

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2012 8 16 8 707 1 1 1 2 1 1 515 39 / 3 P 0. 5 ~ 0. 9 D > 0. 3 3 0. 782 0. 657 0. 842 0. 872 KMO = 0. 821 54. 08% IFI = 0. 905 TLI = 0. 873 CFI = 0. 905 RMSEA = 0. 065 R51 A 1674-3679 2012 08-0707-05 Establishment and evaluation of assessment system of health literacy regarding respiratory infectious diseases SUN Xin-ying 1 LIU Xiao-na 1 CHANG Chun 1 DU Wei-jing 2 TIAN Zhen 1 ZHANG Pei-pei 1. 1. Department of Social Medicine and Health Educaiton School of Public Health Peking University Beijing 100191 China 2. Chinese Center of Health Education Beijing 100011 China Abstract Objective To establish an assessment system to evaluate individual health literacy regarding respiratory infectious diseases by selecting its indexes confirming indexes weights and combining with a comprehensive sustainable index model. Methods A quota sampling was adopted on considering factors including participant s gender age and education background. 515 adults in Beijing took part in the survey conducted by computer assistant. Indexes were selected from original items by difficulty discrimination reliability and validity test. Besides normalization method and variation coefficient approach were applied to identify subjective weights and objective weights. Finally the assessment system was established with the comprehensive index model. Results 39 indexes which constitute of 3 aspects namely knowledge behavior or behavioral intention and relevant skills were selected to evaluate health literacy regarding respiratory infectious diseases. Difficulty coefficients of all indexes ranged from 0. 5 to 0. 9 and discrimination coefficients were all indexes were above 0. 3. Also the Cronbach s alpha coefficients were 0. 782 0. 657 and 0. 842 for the three aspects respectively. After assessment system established by adding weights to indexes and aspects the system demonstrated good internal consistency reliability with a Cronbach s alpha of 0. 872. As for conduct validity 3 factors were extracted from all indexes which explained 54. 08% of variance of the system accumulatively with KMO = 0. 821 and the 3 factors well fitted on confirmatory factor analysis IFI = 0. 905 TLI = 0. 873 CFI = 0. 905 RMSEA = 0. 065. Conclusions The assessment system with good reliability and validity meets aims of the study and can be well applied to evaluate the status of health literacy regarding respiratory infectious diseases. Key words Health literacy Communicable disease Models statistical Chin J Dis Control Prev 2012 16 8 707-711 5U2GGHH000018-02 1 100191 2 100011 1973-1 2 E-mail cchangbj2004@ yahoo. com. cn

708 Chin J Dis Control Prev 2012 Aug 16 8 3 3 2 1 1 n i w i x i i 3 2 g i i 3 p j 1 1. 1 w j = g i / m g i 2 j = 1 3 w j = p j + q j / m p j + q j j = 1 2 m 3 j = 1 515 510 1. 2 67 4 1 2 5 3 / 9 6 4 4 I w 4 i i x i T 16 37 I = n w i x i /T 4 i = 1 1. 5 1 0 4 1. 3 2011 1 0 2 0 2 < 4 1 7 20 min 1. 4 Epi Data 3. 02 SPSS 15. 0 AMOS 6. 0 5 / 2 3 0. 5 < P < 0. 9 D > 0. 3 P 2. 1 489 P = / 95. 9% D 197 40. 3% 106 D = P H - P L P H 27% P L 27% q j w i w i = x i / n 2. 2 51 39 5 9 / 25 18 2. 2. 1 / 5 9 x i i = 1 1 21. 7% 104 21. 3% 53 10. 8% 29 5. 9% 1

2012 8 16 8 709 1 α 0. 782 Table 1 Social-demographic characteristics of the sample population α 0. 78 0. 4 % P < 0. 05 226 46. 2 0. 5 263 53. 8 18 ~ 235 48. 1 30 ~ 156 31. 9 50 ~ 98 20. 0 / / 73 14. 9 / / 179 36. 6 / 237 48. 5 322 65. 8 167 34. 2 456 93. 3 33 6. 7 208 42. 5 / / 281 57. 5 5 P 0. 5 ~ 0. 9 D > 0. 3 4 ~ 9 KMO 2 / 0. 78 0. 71 ~ 0. 89 0. 48 0. 35 ~ 0. 60 Cronbach α 0. 657 / 2. 2. 2 37 25 2 P 0. 74 0. 52 ~ 0. 87 D 0. 46 0. 32 ~ 0. 67 Cronbach α 0. 842 0. 846 54. 84% 0. 74 0. 65 ~ 0. 85 0. 42 0. 39 ~ 0. 53 2. 3 Cronbach 2 Table 2 / Psychometric properties and weighting indexes of health literacy items on knowledge behavior / behavioral intentions and ability regarding respiratory infections 0. 65 0. 53 0. 771 0. 43 0. 58 0. 205 0. 201 0. 203 0. 71 0. 48 0. 765 0. 58 0. 60 0. 212 0. 207 0. 210 0. 73 0. 51 0. 762 0. 56 0. 59 0. 225 0. 187 0. 206 0. 85 0. 39 0. 774 0. 57 0. 67 0. 194 0. 207 0. 200 0. 74 0. 47 0. 773 0. 48 0. 53 0. 164 0. 198 0. 181 / 0. 82 0. 49 0. 643 0. 49 0. 48 0. 122 0. 112 0. 117 0. 84 0. 44 0. 639 0. 52 0. 52 0. 094 0. 115 0. 105 0. 89 0. 60 0. 642 0. 60 0. 58 0. 124 0. 114 0. 119 0. 72 0. 52 0. 590 0. 38 0. 40 0. 112 0. 103 0. 107 0. 75 0. 37 0. 647 0. 42 0. 52 0. 122 0. 118 0. 120 0. 78 0. 48 0. 652 0. 57 0. 49 0. 101 0. 110 0. 105 0. 71 0. 52 0. 587 0. 36 0. 40 0. 098 0. 109 0. 103 0. 78 0. 35 0. 658 0. 41 0. 53 0. 126 0. 114 0. 120 0. 81 0. 42 0. 630 0. 48 0. 57 0. 101 0. 105 0. 104 0. 67 0. 56 0. 834 0. 49 0. 67 0. 040 0. 041 0. 041 0. 54 0. 53 0. 836 0. 46 0. 63 0. 043 0. 039 0. 041 H1N1 0. 54 0. 60 0. 835 0. 47 0. 47 0. 039 0. 038 0. 039

710 Chin J Dis Control Prev 2012 Aug 16 8 0. 83 0. 37 0. 840 0. 44 0. 31 0. 037 0. 041 0. 039 0. 76 0. 47 0. 834 0. 44 0. 46 0. 044 0. 040 0. 042 0. 76 0. 48 0. 834 0. 43 0. 42 0. 035 0. 040 0. 038 OTC 0. 56 0. 49 0. 839 0. 37 0. 47 0. 039 0. 041 0. 040 0. 80 0. 42 0. 834 0. 40 0. 34 0. 045 0. 039 0. 042 0. 87 0. 51 0. 830 0. 42 0. 38 0. 038 0. 039 0. 039 0. 82 0. 51 0. 829 0. 53 0. 52 0. 043 0. 042 0. 043 0. 77 0. 51 0. 827 0. 60 0. 55 0. 038 0. 040 0. 039 0. 78 0. 53 0. 832 0. 48 0. 61 0. 036 0. 039 0. 038 0. 84 0. 31 0. 836 0. 35 0. 47 0. 042 0. 040 0. 040 0. 52 0. 67 0. 833 0. 54 0. 27 0. 037 0. 040 0. 039 0. 74 0. 51 0. 834 0. 44 0. 39 0. 040 0. 040 0. 039 0. 80 0. 49 0. 832 0. 47 0. 40 0. 040 0. 039 0. 040 0. 80 0. 40 0. 835 0. 41 0. 37 0. 042 0. 038 0. 040 0. 83 0. 39 0. 832 0. 44 0. 58 0. 036 0. 041 0. 038 0. 75 0. 41 0. 835 0. 39 0. 43 0. 035 0. 041 0. 038 0. 85 0. 35 0. 836 0. 39 0. 60 0. 043 0. 040 0. 040 0. 69 0. 50 0. 837 0. 41 0. 45 0. 041 0. 041 0. 041 0. 79 0. 56 0. 831 0. 53 0. 55 0. 042 0. 039 0. 041 0. 72 0. 58 0. 833 0. 49 0. 60 0. 043 0. 041 0. 042 0. 78 0. 38 0. 837 0. 38 0. 60 0. 039 0. 042 0. 040 0. 67 0. 32 0. 831 0. 26 0. 16 0. 043 0. 039 0. 041 3 KMO = 0. 821 3 3 0. 30 Table 3 Weighting of three test dimensions of health literacy regarding respiratory infections 2. 52 0. 329 0. 89 0. 333 0. 331 /2. 54 0. 331 0. 88 0. 330 0. 331 2. 61 0. 340 0. 90 0. 337 0. 338 7. 67 1. 000 2. 67 1. 000 1. 000 1 2 = 278. 11 df = 143 P < 2. 4 CFI = 0. 905 RMSEA = 0. 065 2 4 2 9 3 0. 872 0. 7 51 0. 80 8 39 4 Table 4 Reliability analysis of pre-and post-weighting / / 0. 782 0. 657 0. 842 0. 850 0. 795 0. 721 0. 882 0. 872 54. 08% 0. 001 IFI = 0. 905 TLI = 0. 873

2012 8 16 8 711 REALM 10 TOF- HLA 11 2008 12 1991 10 42-44. K1 ~ K5 5 B1 ~ B9 / 7. M. 2002. 9 Prose Document 8 Airasion PW Gay LR. Educational research competencies for a- Quatitative Audiovisual Inform seek nalysis and application M. New Jersey Prentice Hall 2002. 9. 1 J. 2010 42 3 314-317. Figure 1 Confirmatory factor analysis of the assessment system 10 Davis TC Crouch MA Long SW et al. Rapid assessment of literacy levels of adult primary care patients J. Fam Med of health literacy regarding respiratory infectious diseases 1991 23 6 433-435. patients literacy skills J 537-541. 12 13 14 2009. 13. M. 5. 15 2003. 5 14. M. 15 J. 2009 25 5 323-326. 1. Meta J. 2011 15 2 119-122. 2. J. 2010 25 6 540-542. 3 WHO. Health Promotion Glossary R. Geneva 1998. 4 McCormack L Bann C Squiers L et al. Measuring health literacy a pilot study of a new skills-based instrument J. J Health Commun 2010 15 51-71. 5. M. 2008. 6. J. 11 Parker RM Baker DW Williams MV et al. The test of functional health literacy in adults a new instrument for measuring. J Gen Intern Med 1995 10 10. R. 2005.. 2011-11-24 2012-04-06