A multistage research on factors influencing and active learning intervention on health literacy of community-residing elderly adults in Nanjing
Abstract Background The health literacy among older adults deserves further investigation. This study aimed to conduct a multistage research to investigate the current status and key determinants of health literacy among Chinese older adults and evaluate the effectiveness of an active learning inter...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-06-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-025-23394-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849691340666830848 |
|---|---|
| author | Shengxuan Jin Ruobing Fa Jianqian Chao Na Zhang Min Bao Yanqian Wu Leixia Wang Gangrui Tan |
| author_facet | Shengxuan Jin Ruobing Fa Jianqian Chao Na Zhang Min Bao Yanqian Wu Leixia Wang Gangrui Tan |
| author_sort | Shengxuan Jin |
| collection | DOAJ |
| description | Abstract Background The health literacy among older adults deserves further investigation. This study aimed to conduct a multistage research to investigate the current status and key determinants of health literacy among Chinese older adults and evaluate the effectiveness of an active learning intervention in enhancing their health literacy. Methods In the first phase, a cross-sectional study surveyed 608 elderly residents. The second phase was a two-arm parallel randomized controlled trial (RCT) in which 120 older adults were randomly assigned to a three-month intervention (n = 60) or control group (n = 60). The active learning program intervention included health lectures, active discussions, heuristic questioning, and family homework, while the control group only received health literacy pamphlets. Health literacy scores were the primary outcome and were evaluated from five dimensions. The RCT data was collected at baseline and the completion of the intervention. Results In the cross-sectional study, the median (IQR) health literacy score was 4.355 (4.030, 4.647) (range: 0–5) Quantile regression showed that sex, education, number of children, self-reported health, chronic disease and insurance significantly affected health literacy. The intervention group showed significant improvement in all dimensions (P < 0.05), with significant group × time interactions in health knowledge, health behaviours, health skills, health intentions and total health literacy. Multiple linear regression indicated that marriage status related to health knowledge, education level related to health behaviours and total health literacy, chronic diseases and insurance factors related to health skills, and sex and insurance factors related to health intentions have significant effects. Conclusion The health literacy of older adults is influenced by individuals, families, and societal factors. The active learning program effectively enhances comprehensive health literacy and is a valuable strategy for advancing China’s proactive health strategy by mobilizing the roles of the individual, family, and society. Trial registration The trial has been retrospectively registered on April 8, 2025, at the Chinese Clinical Trial Registry (ChiCTR2500100396|| http://www.chictr.org.cn/ ), which is a primary registry of the International Clinical Trial Registry Platform of the World Health Organization. |
| format | Article |
| id | doaj-art-bcc410f15d7641c2994d22c58a9aec0e |
| institution | DOAJ |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-bcc410f15d7641c2994d22c58a9aec0e2025-08-20T03:21:03ZengBMCBMC Public Health1471-24582025-06-0125111310.1186/s12889-025-23394-9A multistage research on factors influencing and active learning intervention on health literacy of community-residing elderly adults in NanjingShengxuan Jin0Ruobing Fa1Jianqian Chao2Na Zhang3Min Bao4Yanqian Wu5Leixia Wang6Gangrui Tan7Health Management Research Center, School of public health, Southeast UniversitySchool of Public Health Management, Jiangsu Health Vocational CollegeHealth Management Research Center, School of public health, Southeast UniversityHealth Management Research Center, School of public health, Southeast UniversityHealth Management Research Center, School of public health, Southeast UniversityHealth Management Research Center, School of public health, Southeast UniversityHealth Management Research Center, School of public health, Southeast UniversityHealth Management Research Center, School of public health, Southeast UniversityAbstract Background The health literacy among older adults deserves further investigation. This study aimed to conduct a multistage research to investigate the current status and key determinants of health literacy among Chinese older adults and evaluate the effectiveness of an active learning intervention in enhancing their health literacy. Methods In the first phase, a cross-sectional study surveyed 608 elderly residents. The second phase was a two-arm parallel randomized controlled trial (RCT) in which 120 older adults were randomly assigned to a three-month intervention (n = 60) or control group (n = 60). The active learning program intervention included health lectures, active discussions, heuristic questioning, and family homework, while the control group only received health literacy pamphlets. Health literacy scores were the primary outcome and were evaluated from five dimensions. The RCT data was collected at baseline and the completion of the intervention. Results In the cross-sectional study, the median (IQR) health literacy score was 4.355 (4.030, 4.647) (range: 0–5) Quantile regression showed that sex, education, number of children, self-reported health, chronic disease and insurance significantly affected health literacy. The intervention group showed significant improvement in all dimensions (P < 0.05), with significant group × time interactions in health knowledge, health behaviours, health skills, health intentions and total health literacy. Multiple linear regression indicated that marriage status related to health knowledge, education level related to health behaviours and total health literacy, chronic diseases and insurance factors related to health skills, and sex and insurance factors related to health intentions have significant effects. Conclusion The health literacy of older adults is influenced by individuals, families, and societal factors. The active learning program effectively enhances comprehensive health literacy and is a valuable strategy for advancing China’s proactive health strategy by mobilizing the roles of the individual, family, and society. Trial registration The trial has been retrospectively registered on April 8, 2025, at the Chinese Clinical Trial Registry (ChiCTR2500100396|| http://www.chictr.org.cn/ ), which is a primary registry of the International Clinical Trial Registry Platform of the World Health Organization.https://doi.org/10.1186/s12889-025-23394-9Health literacyActive learning programInterventionElderly adultProactive health |
| spellingShingle | Shengxuan Jin Ruobing Fa Jianqian Chao Na Zhang Min Bao Yanqian Wu Leixia Wang Gangrui Tan A multistage research on factors influencing and active learning intervention on health literacy of community-residing elderly adults in Nanjing BMC Public Health Health literacy Active learning program Intervention Elderly adult Proactive health |
| title | A multistage research on factors influencing and active learning intervention on health literacy of community-residing elderly adults in Nanjing |
| title_full | A multistage research on factors influencing and active learning intervention on health literacy of community-residing elderly adults in Nanjing |
| title_fullStr | A multistage research on factors influencing and active learning intervention on health literacy of community-residing elderly adults in Nanjing |
| title_full_unstemmed | A multistage research on factors influencing and active learning intervention on health literacy of community-residing elderly adults in Nanjing |
| title_short | A multistage research on factors influencing and active learning intervention on health literacy of community-residing elderly adults in Nanjing |
| title_sort | multistage research on factors influencing and active learning intervention on health literacy of community residing elderly adults in nanjing |
| topic | Health literacy Active learning program Intervention Elderly adult Proactive health |
| url | https://doi.org/10.1186/s12889-025-23394-9 |
| work_keys_str_mv | AT shengxuanjin amultistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT ruobingfa amultistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT jianqianchao amultistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT nazhang amultistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT minbao amultistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT yanqianwu amultistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT leixiawang amultistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT gangruitan amultistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT shengxuanjin multistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT ruobingfa multistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT jianqianchao multistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT nazhang multistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT minbao multistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT yanqianwu multistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT leixiawang multistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing AT gangruitan multistageresearchonfactorsinfluencingandactivelearninginterventiononhealthliteracyofcommunityresidingelderlyadultsinnanjing |