A national health literacy scale was developed in China in 2012, though no studies have validated it. In this investigation, we assessed the reliability, construct validity, and measurement invariance of that scale. A population-based sample of 3731 participants in Hunan Province was used to validate the Chinese Resident Health Literacy Scale based on item response theory and classical test theory (including split-half coefficient, Cronbach’s alpha, and confirmatory factor analysis). Measurement invariance was examined by differential item functioning. The overall Cronbach’s alpha of the scale was 0.95 and Spearman-Brown coefficient 0.94. Confirmatory factor analysis showed that the test measured a unidimensional construct with three highly correlated factors. Highest discrimination was found among participants with limited to moderate health literacy. In all, 64 items were selected from the original scale based on factor loading, Pearson’s correlation coefficient, and discrimination and difficulty parameters in item response theory. Measurement invariance was significant but slight. According to the two-level linear model, health literacy was associated with education level, occupation, and income. The 2012 national health literacy scale was validated, and 64 items were selected based on classical test theory and item response theory. The revised version of the scale has strong psychometric properties with minor measurement invariance.

/pdf/assessment-of-the-chinese-resident-health-literacy-scale-in-3n9udmpwnc.pdf

Assessment of the Chinese Resident Health Literacy Scale in a population-based sample in South China

Improving health literacy is an important public health goal in many countries. Although many studies have suggested that low health literacy has adverse effects on an individual’s health outcomes, confounding factors are often not accounted. This paper examines the interplay between health literacy and chronic disease prevention. A population-based sample of 8194 participants aged 15–69 years old in Ningbo were used from China’s 2017 National Health Literacy Surveillance Data. We use multivariate regression analysis to disentangle the relationship between health literacy and chronic disease prevention. We find the association between health literacy and the occurrence of the first chronic condition is attenuated after we adjust the results for age and education. This might arise because having one or more chronic conditions is associated with better knowledge about chronic diseases, thus improve their health literacy. More importantly, we find health literacy is associated with a reduction in the likelihood of having a comorbid condition. However, this protective effect is only found among urban residents, suggesting health literacy might be a key factor explaining the rural-urban disparity in health outcomes. Our findings highlight the important role of health literacy in preventing comorbidities instead of preventing the first chronic condition. Moreover, family support could help improve health literacy and result in beneficial effects on health.

/pdf/health-literacy-and-its-effect-on-chronic-disease-prevention-3p3bv6fvgb.pdf

Health literacy and its effect on chronic disease prevention: evidence from China's data.

We examined the relationship between health literacy (HL) and health-related quality of life (HRQoL) as well as relationship differentials by ethnicity among rural women from a Chinese poor minority area. We conducted in-person interviews with 913 rural women aged 23 – 57 (57.5% Hui minorities/42.5% Han ethnicity) enrolled in the Ningxia Women Health Project, gathering data on EQ-5D, self-designed HL, socio-demographic characteristics, and chronic diseases. The extent of impairments in the five dimensions of the EQ-5D was used to measure HRQoL. Factor analysis yielded a single HL factor, which was used as a dichotomous variable in multivariate log-binomial regression models that examined the adjusted association of HL with HRQoL. Nearly half of the women had no formal education. The most prevalent impairments were pain/discomfort and anxiety/depression (42.42% and 32.09%, respectively). The Hui minorities had 1.65 times higher rates of low HL (defined as less than mean of the factor score for HL) and 1.22 and 1.25 times for pain/discomfort and anxiety/depression impairments, respectively. Low HL was associated with poor HRQoL, with a 23% increase in the prevalence of pain/discomfort impairments after adjusting for socio-demographics. This association was significant in the Hui group (PR=1.30, 95% CI=1.06-1.58) but not for the Han group (PR=0.99, 95% CI=0.76-1.30). HL-stratified analysis revealed modification for ethnic disparities in HRQoL; for pain/discomfort impairments, high HL-PR=0.88 (95% CI=0.71-1.08), low HL-PR=1.24 (95% CI = 1.01-1.52); for anxiety/depression impairments, high HL-PR=0.98 (95% CI=0.73-1.32), low HL-PR=1.44 (95% CI = 1.05-1.98). Low HL is associated with poor HRQoL across the entire sample and the association may be modified by ethnicity. Similarly, ethnic disparities in HRQoL may be modified by HL, larger in low HL group. Health services should address HL in vulnerable minority women to improve their HRQoL.

/pdf/health-literacy-and-ethnic-disparities-in-health-related-12tja1ovyx.pdf

Health literacy and ethnic disparities in health-related quality of life among rural women: results from a Chinese poor minority area.

Health literacy and health-information seeking behaviour (HISB) play vital roles in health outcome improvements. This study examines the extent of income-related inequality in health literacy and health-information seeking as well as the contributions of the main socioeconomic determinants in China. We analysed representative data of participants aged over 18 years as well as older adults from the Guangzhou Community Health Survey. A concentration index (CI) was used to quantify the degree of income-related inequity in health literacy and health-information seeking. Probit regression models were employed to decompose the CI into the contributions to each factor. Results showed a significant pro-rich distribution of adequate health literacy (CI: 0.0602, P < 0.001; horizontal index [HI]: 0.0562, P < 0.001) and HISB from healthcare professionals (CI: 0.105, P < 0.001; HI: 0.0965, P < 0.001). The pro-rich distribution of health literacy was mainly attributable to education background (contribution: 54.76%), whereas income inequalities contributed most to the pro-rich distribution of health-information seeking among an urban population (contribution: 62.53%). Public interventions in China to reduce inequality in health literacy and HISBs among the urban population, coupled with easily accessible information sources on health, warrant further attention from policymakers.

/pdf/examining-income-related-inequality-in-health-literacy-and-1tx5ob6b0y.pdf

Examining income-related inequality in health literacy and health-information seeking among urban population in China.

Physical activity and good nutrition are important behavioral factors in promoting health and preventing disease. It is important to understand the factors affecting physical activity and nutrition. The purpose of this study was to explore whether social capital has an effect on physical activity and nutrition, and whether health literacy plays a mediating role between social capital and physical activity as well as nutrition. This cross-sectional study was performed in a certain district of Shanghai in March and April 2017. Data was collected using a self-reported questionnaire, which included questions on sociodemographic characteristics, social capital, health literacy and health-promoting lifestyle profile-II. Health-promoting lifestyle profile-II measures the behaviours or habits of physical activity and healthy nutrition. An explore factor analysis of the principal components with varimax rotation was carried out on the social capital scale. Descriptive statistics was used to summarize the sociodemographic of participants. Mediation analysis was performed using the bootstrapping tests to examine whether health literacy mediate the relationship between social capital and physical activity as well as nutrition. The explore factor analysis results showed that social capital has five dimensions, namely social participation, social support, social network, control over life and feelings about the community. There is a positive correlation between social capital, health literacy, physical activity and nutrition. The correlation coefficient varied from 0.135 to 0.594. Mediation analysis demonstrated health literacy played a partial mediating effect between social capital and physical activity as well as nutrition. In the relationship between physical activity and social capital, the indirect effect of health literacy accounted for 8.20 to 12.65% of the total effect. In the relationship between nutrition and social capital, the mediation effect of health literacy accounted for 4.93 to 12.71% of the total effect. Social capital can promote physical activity and nutrition by disseminating health information. Enhancing the social capital of residents will help increase physical activity and develop healthy eating habits. Attention should also be paid to the improvement of residents’ health literacy.

/pdf/the-impact-of-social-capital-on-physical-activity-and-3w6ryx0cbl.pdf

The impact of social capital on physical activity and nutrition in China: the mediating effect of health literacy

目的 应用Delphi法筛选中国公众健康素养评价指标.方法 根据研究主题确定咨询专家人选,采用Delphi法进行问卷调查.结果 专家的平均年龄45.59±8.98岁,大部分具有副高以上职称,平均工作年限23.25±8.61年;两轮咨询问卷回收率均高于80%,专家权威程度均为0.86;根据设定的重要性得分均数和变异系数标准筛选出符合要求的评价指标60项,分别评价健康素养的4个部分:健康知识、健康行为、健康信念和健康技能;经过两轮咨询后,专家协调系数为0.240,具有统计学差异(P<0.05).结论 专家代表性强,积极性高,权威程度、协调性较好,此次咨询筛选出指标的符合构建健康素养评价指标体系的需要.

A study on applying Delphi method for screening evaluation indexes of health literacy of China adults

Objective To explore the effect of phosphorus (P),nitrogen (N) and N/P ratio on the growth of Microcystis aeruginosa strains. Methods Cultured the microcystis that carried out ampliative culture three times in N and P free culture. Inoculated the microcystis to the cultures in which P concentration was 0, 0.5, 1.0, 5.0, 10.0 mg/L respectively and cultured for 19 days. Inoculated the microcystis to the BG-11 cultures in which P concentration was 0.05 mg/L and 5.0 mg/L, add in NaNO3 according to the mol ratio of N/P was 5∶1, 10∶1, 20∶1, 50∶1, 100∶1, and cultured for 19 days. The changes of the count of the microcystis and the concentration of P were observed. Results At beginning, the microcystis in lower P concentration cultures growed better than the microcystis in the higher P concentration, but there was not much difference. At the late exponential phase, the biomass of the microcystis in the higher P concentration cultures exceeded the microcystis in the lower P concentration cultures. Afterward, the microcystis in the cultures ceased growing. And the exponential phase of the microcystis in higher P concentration cultures was longer than the microcystis in lower P concentration cultures. The difference in maximum biomass among each cultures that initial P concentration was 0.05 mg/L was not significant (P0.05), but that was significant at the cultures in which the concentration of phosphorus was 5 mg/L(P0.05). The results was 20∶110∶15∶150∶1100∶1. The specific growth rate of microcystis and P concentration in different P concentration and different N/P ratio cultures decreased with the culture time. Conclusions The initial P concentration affects the microcystis yield significantly, N/P ratio should be concerned in confirming the limiting factor. To control the P concentration in water through different methods will be the effective way to control water bloom.

Effects of Nitrogen and Phosphorus on Growth of Microcystis aeruginosa Strains


 目的： 探讨利用"两针固定法"预防合并高危因素直肠癌患者在乙状结肠单腔造口术后造口脱垂等并发症的临床疗效。 方法： 采用回顾性队列研究方法。收集自2015年1月至2020年6月期间，在郑州大学附属肿瘤医院连续收治的行腹会阴联合直肠癌根治（Miles）乙状结肠单腔造口手术的232例患者的临床病理资料，根据造口固定方式的不同分为两针固定组（102例）和传统固定组（130例）。两组患者基线资料差异无统计学意义（均P>0.05）。比较两组的手术时间、术后造口脱垂及其他相关并发症的发生率和转归。 结果： 两组患者均顺利完成手术，均无术中严重并发症的发生。两针固定组手术时间较传统固定组明显缩短[（1.4±0.3）d比（6.3±0.7）d，t=-65.615，P<0.001]，造口脱垂[2.0%（2/102）比12.3%（16/130），χ(2)=8.550，P=0.003]、皮肤黏膜分离[3.9%（4/102）比20.0%（26/130），χ(2)=13.123，P<0.001]、造口回缩[0比14.6%（19/130），χ(2)=16.237，P<0.001]发生率明显降低，差异均有统计学意义（P<0.05）。两组术后造口旁疝及造口周围皮炎发生率的差异，均无统计学意义（均P>0.05）。 结论： 对于合并高危因素的低位直肠癌患者，两针固定法固定Miles术乙状结肠单腔造口可以有效降低术后造口脱垂等并发症的发生。.


Ma Yu

Papers

A study on applying Delphi method for screening evaluation indexes of health literacy of China adults

Effects of Nitrogen and Phosphorus on Growth of Microcystis aeruginosa Strains

[Preventive efficacy of two-stitch fixation method on stoma prolapse after sigmoid colon single-chamber ostomy].