Health Literacy Among University Students in Shaanxi Province of China: A Cross-Sectional Study

Figures & data

Table 1 Scale Validity

Dimensions	Items	Standardised Loads	CR	AVE
Knowledge	Q1	0.749	0.903	0.511
	Q2	0.768
	Q3	0.669
	Q4	0.784
	Q5	0.785
	Q6	0.616
	Q7	0.660
	Q8	0.651
	Q9	0.728
Attitude	Q10	0.894	0.981	0.851
	Q11	0.933
	Q12	0.946
	Q13	0.964
	Q14	0.948
	Q15	0.928
	Q16	0.910
	Q17	0.903
	Q18	0.874
Practice	Q19	0.890	0.976	0.822
	Q20	0.920
	Q21	0.924
	Q22	0.875
	Q23	0.880
	Q24	0.929
	Q25	0.925
	Q26	0.908
	Q27	0.907

Table 2 Overall Health Literacy

Variables	n=1578	Percentage	Total Score	Knowledge	Attitude	Practice
Gender
Male	756	47.9%	104.794±10.755	35.812±4.419	33.836±4.219	35.146±4.714
Female	822	52.1%	105.822±9.513	36.35±3.957	34.493±4.213	34.979±4.325
t value			4.064	6.514	9.557	0.533
p value			0.044	0.011	0.002	0.465
Discipline
Literature, History, Law, Philosophy	303	19.2%	105.142±9.085	36.086±4.143	34.069±3.557	34.987±4.29
Engineering, Agriculture, Medicine	338	21.4%	106.692±11.664	36.657±4.616	34.393±3.889	35.642±5.031
Economics and Management	328	20.8%	104.716±9.838	35.918±4.107	34.223±4.454	34.576±4.451
Education	313	19.8%	106.058±9.048	36.102±3.755	34.93±4.282	35.026±4.154
Arts	296	18.8%	103.875±10.5	35.639±4.22	33.199±4.72	35.037±4.511
F value			3.807	2.552	6.820	2.380
p value			0.004	0.037	0.000	0.050
Grades
Freshman	381	24.1%	105.882±10.414	36.509±4.281	33.84±4.034	35.533±4.717
Sophomore	367	23.3%	106.019±10.165	36.025±4.219	34.706±3.772	35.289±4.54
Junior	354	22.4%	105.26±10.148	36.011±4.053	34.641±4.629	34.607±4.425
Senior	205	13.0%	105.707±8.184	36.063±3.619	35.146±4.162	34.498±4.062
Postgraduate	271	17.2%	103.424±10.834	35.727±4.577	32.601±4.128	35.096±4.566
F value			3.194	1.518	15.787	2.984
p value			0.013	0.194	0.000	0.018
Family location
Urban area	684	43.3%	106.504±10.711	36.541±4.361	34.232±4.164	35.731±4.777
Rural area	894	56.7%	104.431±9.583	35.749±4.027	34.136±4.276	34.545±4.235
t value			16.376	13.928	0.200	27.196
p value			0.000	0.000	0.655	0.000
Health Education Experience
Yes	889	56.3%	106.431±10.128	36.394±4.098	34.828±4.508	35.209±4.609
No	689	43.7%	103.909±9.977	35.704±4.281	33.340±3.670	34.865±4.386
t value			24.389	10.574	120.598	2.258
p value			0.000	0.001	0.000	0.133
Mean Score				36.093±4.192	34.178±4.227	35.059±4.515

Notes: Test ANOVA. The descriptive variables (mean and standard deviation) are shown with the degree of perceived difficulty in each situation proposed in the survey.

Table 3 Health Literacy Items

Indicators and Items	Scores	Average Scores	95% CI
Knowledge	45	36.09	35.89–36.30
Q1. If I am scratched or bitten by a dog or cat, I will immediately rinse the wound and get a human rabies vaccination at the hospital as soon as possible.	5	4.36	4.32–4.39
Q2. I know that HIV, hepatitis B and hepatitis C are transmitted through blood, sexual contact and mother-to-child contact, but not through daily or work contact.	5	3.57	3.51–3.62
Q3. I know that proper hand washing and hand hygiene can help prevent influenza.	5	4.23	4.19–4.27
Q4.I believe that everyone has a duty to report any cases of infectious disease in their neighbourhood to the CDC.	5	4.35	4.32–4.39
Q5. I know that is illegal to hide my personal journey and cause the spread of an epidemic, or to “fail to attend an organised nucleic acid test” for no good reason.	5	4.22	4.18–4.26
Q6. I know that eat a light diet, with less oil, salt and sugar is benefit for health.	5	3.32	3.26–3.37
Q7. I know that exercising 6000 to 10,000 steps a day is good for your health.	5	3.71	3.66–3.75
Q8. I know that using condoms correctly reduces the risk of contracting HIV and STIs and prevents unwanted pregnancies.	5	4.18	4.14–4.22
Q9. I store and process raw and cooked food separately, wash raw vegetables and fruits, and do not eat food that has spoiled or exceeded its shelf life.	5	4.16	4.11–4.20
Attitude	45	34.18	33.97–34.39
Q10. I do not use communal spoons and chopsticks when I eat with friends and family. (reverse questions)	5	3.14	3.08–3.19
Q11. I have common medical and first aid supplies at home.	5	3.98	3.94–4.02
Q12. I believe that if I have anxiety, depression, fear, despair or other psychological problems during a major infectious disease epidemic, I should manage them on my own.	5	3.23	3.17–3.28
Q13. I believe that whether or not to seek medical treatment for an infectious disease is a personal matter and that others have no right to interfere.	5	4.11	4.07–4.15
Q14. I will actively cooperate with medical and health personnel in taking emergency measures such as investigation, isolation, disinfection and vaccination.	5	4.045	4.01–4.09
Q15. I will not smoke or spit in public places and will cover my mouth and nose if I cough or sneeze.	5	3.54	3.48–3.59
Q16. I will read packaging, labels and instructions carefully before buying food, medicines and health products.	5	4.22	4.19–4.26
Q17. I understand the outbreak through official media reports and do not listen to other sources of information.	5	3.85	3.79–3.85
Q18. I can recognise common hazard signs such as high pressure, flammable, explosive, highly toxic, radioactive, biosecurity, etc.	5	4.07	4.03–4.11
Practice	45	35.06	34.84–35.28
Q19. To take my temperature, I would shake the thermometer below 35°C, place it under my armpit against my skin and remove it after 5 minutes to take a reading.	5	4.14	4.10–4.19
Q20. When taking blood pressure, I wrap the cuff around my elbow 2–3cm above my heart and place it as tightly as possible to fit one finger in.	5	4.01	3.96–4.05
Q21. In the event of an earthquake when I am working or studying in a building, I will take the lift and evacuate as quickly as possible.	5	2.53	2.46–2.60
Q22. In the event of a flood, I will evacuate in an orderly manner and in accordance with the principles of moving people before things.	5	4.32	4.29–4.36
Q23. If I smell a strong smell of gas when I return home from work, I will turn on the lights as soon as possible to check for gas leaks.	5	3.30	3.24–3.37
Q24. When performing chest compressions on adults, I apply compressions at a depth of 5–6cm and at a rate of 100–120 compressions per minute.	5	3.90	3.86–3.94
Q25. When resuscitating a person who has been electrocuted, I cut off the power supply first and do not touch the person directly.	5	4.36	4.32–4.39
Q26. If someone near me has an epileptic fit, I will put strips of wood or cloth in their mouth to prevent them from biting their tongue. (reverse questions)	5	4.15	4.12–4.19
Q27. When escaping from a fire, I will cover my mouth and nose with a wet towel, stay low and call the fire alarm number 119.	5	4.34	4.31–4.38

Notes: Test ANOVA. The descriptive variables (mean and standard deviation) are shown with the degree of perceived difficulty in each situation proposed in the survey (“strongly agree” (5 points), “agree” (4 points), “average” (3 points), “disagree” (2 points) and “strongly disagree” (1 point)).

Table 4 Correlation Analysis

	Knowledge	Attitude	Practice	Mean	Std. Deviation
Knowledge	1			36.093	4.192
Attitude	0.600**	1		34.178	4.227
Practice	0.668**	0.446**	1	35.059	4.515

Notes: Pearson Correlation. **: Correlation is significant at the 0.01 level.

Table 5 Health Knowledge Score

Variables	n=1578	Percentage	Knowledge of Disease Prevention	Knowledge of Policies and Regulations	Knowledge of Healthy Living	Total Score
Gender
Male	756	47.9%	12.114±1.906	8.418±1.508	15.28±2.572	35.812±4.419
Female	822	52.1%	12.196±1.781	8.72±1.227	15.434±2.497	36.35±3.957
t value			0.782	19.204	1.453	6.514
p value			0.377	0.000	0.228	0.011
Discipline
Literature, History, Law, Philosophy	303	19.2%	12.046±1.835	8.538±1.395	15.502±2.474	36.086±4.143
Engineering, Agriculture, Medicine	338	21.4%	12.308±1.817	8.621±1.495	15.728±2.463	36.657±4.616
Economics and Management	328	20.8%	12.22±1.867	8.631±1.249	15.067±2.605	35.918±4.107
Education	313	19.8%	12.275±1.729	8.607±1.299	15.22±2.495	36.102±3.755
Arts	296	18.8%	11.902±1.943	8.466±1.43	15.27±2.591	35.639±4.22
F value			2.682	0.791	3.466	2.552
p value			0.030	0.531	0.008	0.037
Grades
Freshman	381	24.1%	12.323±1.935	8.69±1.456	15.496±2.547	36.509±4.281
Sophomore	367	23.3%	12.084±1.806	8.526±1.336	15.414±2.531	36.025±4.219
Junior	354	22.4%	12.164±1.796	8.576±1.271	15.271±2.544	36.011±4.053
Senior	205	13.0%	12.215±1.775	8.571±1.217	15.278±2.373	36.063±3.619
Postgraduate	271	17.2%	11.967±1.857	8.483±1.549	15.277±2.628	35.727±4.577
F value			1.691	1.086	0.552	1.518
p value			0.150	0.362	0.698	0.194
Family location
Urban area	684	43.3%	12.237±1.825	8.637±1.418	15.667±2.617	36.541±4.361
Rural area	894	56.7%	12.095±1.854	8.528±1.342	15.126±2.443	35.749±4.027
t value			2.296	2.453	17.811	13.928
p value			0.130	0.117	0.000	0.000
Health Education Experience
Yes	889	56.3%	12.27±1.862	8.637±1.274	15.487±2.576	36.394±4.098
No	689	43.7%	12.01±1.807	8.496±1.495	15.197±2.469	35.704±4.281
t value			7.753	4.041	5.088	10.574
p value			0.005	0.045	0.024	0.001

Notes: Test ANOVA. The descriptive variables (mean and standard deviation) are shown with the degree of perceived difficulty in each situation proposed in the survey.

Table 6 Health Attitudes Score

Variables	n=1578	Percentage	Awareness of Self-Protection	Awareness of Responsibility	Awareness of Information Screening	Scores
Gender
Male	756	47.9%	10.266±1.906	11.405±1.913	12.165±2.098	33.836±4.219
Female	822	52.1%	10.412±1.831	11.961±1.936	12.119±2.117	34.493±4.213
t value			2.426	32.896	0.188	9.557
p value			0.120	0.000	0.664	0.002
Discipline
Literature, History, Law, Philosophy	303	19.2%	10.413±1.835	11.422±1.609	12.234±1.955	34.069±3.557
Engineering, Agriculture, Medicine	338	21.4%	10.47±1.833	11.719±1.46	12.204±2.116	34.393±3.889
Economics and Management	328	20.8%	10.14±1.901	11.893±2.31	12.189±2.02	34.223±4.454
Education	313	19.8%	10.498±1.776	12.144±2.128	12.288±2.133	34.93±4.282
Arts	296	18.8%	10.182±1.975	11.25±1.971	11.767±2.281	33.199±4.72
F value			2.563	10.655	2.992	6.820
p value			0.037	0.000	0.018	0.000
Grades
Freshman	381	24.1%	10.457±1.811	11.197±1.743	12.186±2.212	33.84±4.034
Sophomore	367	23.3%	10.403±1.943	11.956±1.597	12.346±1.874	34.706±3.772
Junior	354	22.4%	10.24±1.903	12.251±2.182	12.15±2.186	34.641±4.629
Senior	205	13.0%	10.463±1.816	12.376±2.079	12.307±1.932	35.146±4.162
Postgraduate	271	17.2%	10.14±1.822	10.797±1.686	11.664±2.218	32.601±4.128
F value			1.732	39.389	4.745	15.787
p value			0.140	0.000	0.001	0.000
Family location
Urban area	684	43.3%	10.363±1.899	11.621±1.873	12.249±2.071	34.232±4.164
Rural area	894	56.7%	10.327±1.845	11.751±1.996	12.059±2.133	34.136±4.276
t value			0.143	1.713	3.129	0.200
p value			0.705	0.191	0.077	0.655
Health Education Experience
Yes	889	56.3%	10.372±1.919	12.151±2.175	12.305±2.073	34.828±4.508
No	689	43.7%	10.303±1.799	11.106±1.393	11.930±2.135	33.340±3.670
t value			120.598	12.343	49.602	120.598
p value			0.000	0.000	0.000	0.000

Notes: Test ANOVA. The descriptive variables (mean and standard deviation) are shown with the degree of perceived difficulty in each situation proposed in the survey.

Table 7 Health Practices Score

Variables	n=1578	Percentage	Injury Detection Skills	Life Safety Skills	First Aid Skills	Total Score
Gender
Male	756	47.9%	8.009±1.454	10.358±2.424	16.778±2.332	35.146±4.714
Female	822	52.1%	8.274±1.359	9.977±2.411	16.729±2.146	34.979±4.325
t value			13.947	9.811	0.189	0.533
p value			0.000	0.002	0.663	0.465
Discipline
Literature, History, Law, Philosophy	303	19.2%	8.162±1.316	10.191±2.117	16.634±2.196	34.987±4.29
Engineering, Agriculture, Medicine	338	21.4%	8.237±1.499	10.396±2.537	17.009±2.346	35.642±5.031
Economics and Management	328	20.8%	8.049±1.407	9.866±2.568	16.662±2.224	34.576±4.451
Education	313	19.8%	8.073±1.409	10.022±2.436	16.93±2.102	35.026±4.154
Arts	296	18.8%	8.216±1.407	10.328±2.384	16.493±2.271	35.037±4.511
F value			1.138	2.641	2.960	2.380
p value			0.337	0.032	0.019	0.050
Grades
Freshman	381	24.1%	8.244±1.48	10.236±2.488	17.052±2.207	35.533±4.717
Sophomore	367	23.3%	8.223±1.332	10.289±2.338	16.777±2.23	35.289±4.54
Junior	354	22.4%	8.119±1.364	9.862±2.507	16.627±2.3	34.607±4.425
Senior	205	13.0%	8.141±1.304	9.8±2.356	16.556±2.179	34.498±4.062
Postgraduate	271	17.2%	7.948±1.536	10.539±2.323	16.609±2.218	35.096±4.566
F value			2.106	4.518	2.689	2.984
p value			0.078	0.001	0.030	0.018
Family location
Urban area	684	43.3%	8.32±1.454	10.433±2.471	16.978±2.297	35.731±4.777
Rural area	894	56.7%	8.015±1.363	9.951±2.368	16.579±2.175	34.545±4.235
t value			18.381	15.457	12.401	27.196
p value			0.000	0.000	0.000	0.000
Health Education Experience
Yes	889	56.3%	8.28±1.316	10.098±2.621	16.831±2.25	35.209±4.609
No	689	43.7%	7.975±1.509	10.239±2.144	16.65±2.217	34.865±4.386
t value			18.306	1.325	2.546	2.258
p value			0.000	0.250	0.111	0.133

Notes: Test ANOVA. The descriptive variables (mean and standard deviation) are shown with the degree of perceived difficulty in each situation proposed in the survey.

Table 8 Distribution of Students with Adequate Health Literacy

Variables	Participants	Knowledge		Attitude		Practice		Total Scores
		Number	Percentage	Number	Percentage	Number	Percentage	Number	Percentage
Gender
Male	756	261	34.5%	412	54.5%	359	47.5%	280	37.0%
Female	822	335	40.8%	503	61.2%	373	45.4%	339	41.2%
χ2 value		6.504		7.245		0.705		2.919
p value		0.011		0.007		0.401		0.088
Discipline
Literature, History, Law, Philosophy	303	103	34.0%	177	58.4%	149	49.2%	116	38.3%
Engineering, Agriculture, Medicine	338	144	42.6%	203	60.1%	166	49.1%	146	43.2%
Economics and Management	328	124	37.8%	189	57.6%	141	43.0%	119	36.3%
Education	313	142	45.4%	186	59.4%	143	45.7%	131	41.9%
Arts	296	83	28.0%	160	54.1%	133	44.9%	107	36.1%
χ2 value		24.806		2.782		3.794		5.622
p value		0.000		0.595		0.435		0.229
Grades
Freshman	381	129	33.9%	230	60.4%	178	46.7%	156	40.9%
Sophomore	367	162	44.1%	205	55.9%	191	52.0%	148	40.3%
Junior	354	152	42.9%	211	59.6%	157	44.4%	141	39.8%
Senior	205	93	45.4%	126	61.5%	85	41.5%	82	40.0%
Postgraduate	271	60	22.1%	143	52.8%	121	44.6%	92	33.9%
χ2 value		46.041		5.996		7.656		0.931
p value		0.000		0.199		0.105		0.415
Family location
Urban area	684	268	39.2%	423	61.8%	357	52.2%	296	43.3%
Rural area	894	328	36.7%	492	55.0%	375	41.9%	323	36.1%
χ2 value		1.024		7.374		16.36		8.299
p value		0.312		0.007		0.000		0.004
Health Education Experience
Yes	889	403	45.3%	543	61.1%	433	48.7%	395	44.4%
No	689	193	28.0%	372	54.0%	299	43.4%	224	32.5%
χ2 value		49.542		8.006		4.401		23.139
p value		0.000		0.005		0.036		0.000