呼吸道传染病健康素养综合评价体系的建立与评估

Establishment and evaluation of assessment system of health literacy regarding respiratory infectious diseases

目的筛选评价呼吸道传染病健康素养的指标,确定评价指标和维度的权重系数,建立并评估呼吸道传染病健康素养的综合评价体系。方法依据性别、年龄、教育程度较均衡的配额抽样方法在北京市海淀区随机抽取了515名成人进行计算机辅助技术的问卷调查。通过难度、区分度、信度和效度检验筛选出测评指标;利用归一化法和变异系数法分别得到主观权重和客观权重,并利用综合指数模型最终构建评价体系。结果共筛选39个指标,从知识、行为/行为意向、能力3个维度评价呼吸道传染病健康素养。各指标难度P均在0.5～0.9范围内,区分度D>0.3,3个维度的内部一致性系数分别为0.782、0.657和0.842,赋权重后综合评价一致性信度达到0.872,二次探索性因子分析结果显示评价体系符合设定维度的划分(KMO=0.821,可解释方差为54.08%),以验证性因子分析进行验证,拟合优度良好(IFI=0.905,TLI=0.873,CFI=0.905,RMSEA=0.065)。结论本研究所开发的呼吸道传染病健康素养评价工具及体系的难易度、区分度、信度、效度均较好,可以用来测评公众的呼吸道传染病健康素养水平。

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 sustainble 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 O. 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.