Assessing Health Literacy and Outcomes in China

In this survey, the method of questionnaire survey and household survey are both adopted. The questionnaire is completed by the respondents. If the respondents can not complete the questionnaire independently, it will be surveyed by face-to-face inquiry. Before the survey, investigators were trained standardly to ensure the consistency of survey method used. During the survey, the on-site coordinators will supervise and verify whether the investigators comply with the survey technical specifications. After the survey, the disease control department will conduct quality control by checking the answer time in the system background, extracting sound recordings and on-site review, exclude the unqualified questionnaires, and select new respondents again, so as to obtain all the qualified data finally.
The questionnaire includes three parts: General information survey, Health literacy survey and Health status survey. The general information survey mainly collects the age, gender, profession, education level, income level and other information of the respondents. Health literacy was assessed by the Chinese Citizen Health Literacy Questionnaire, which was designed by Delphi method [22 (link)]. Experts in the fields of public health, health education and promotion, and clinical medicine jointly designed this questionnaire. And the respondents of this questionnaire are permanent urban and rural residents aged 15–69 in China. The overall Cronbach’s alpha of the questionnaire was 0.95 and Spearman-Brown coefficient was 0.94 [23 (link)]. This questionnaire is not only used in the annual China Health Literacy Survey (CHLS) [24 (link)], but also in many studies on health literacy in China [25 (link)–27 ]. The health status survey part is used to investigate the health outcomes of recent chronic diseases and self-rated health status.