Abstract：Objective To analyze the factors affecting health literacy level and its internal transformation relationship amongst residents in Changsha City, and to determine the best way to improve the residents' health literacy. Methods A stratified multi-stage random sampling method was used to select 4,701 permanent residents aged 15-69 years in districts and counties of Changsha City to serve as the research subjects. The distribution of each health literacy level was assessed by descriptive analysis. Multivariate logistic regression analysis was performed to identify the factors influencing basic health literacy, and path analysis to explore the internal cause-and-effect transformation relationship based on three aspects of health literacy. Results The attainment rates of basic health literacy, basic knowledge and concepts, healthy skills and healthy lifestyle and behavior in the residents in Changsha City were 25.27% (95%CI:24.03%-26.51%), 41.37% (95%CI:39.96%-42.78%), 25.25% (95%CI:24.62%-25.88%) and 27.97% (95%CI:27.32%-28.62%) respectively. The results of logistic regression analysis revealed that age (26-36 years old: OR=1.931, 95%CI:1.491-2.500; 37-47 years old: OR=1.850, 95%CI:1.442-2.373; 48-58 years old: OR=1.531, 95%CI:1.207-1.941), education level (middle school: OR=2.020, 95%CI:1.518-2.686; high school/vocational high school/secondary technical school: OR=3.343, 95%CI:2.456-4.551; college/bachelor degree or above: OR=4.532, 95%CI:3.237-6.345), occupation (medical professionals: OR=4.260, 95%CI:2.674-6.788), and per capita annual household income (15,001-<40,000 yuan per year: OR=1.770, 95%CI:1.411-2.219; ≥ 40,000 yuan per year: OR=1.672, 95%CI:1.265-2.210) were the factors influencing health literacy of the residents. Path analysis displayed that the standardized direct path coefficients of the three constructed paths were 0.748, 0.549 and 0.300 respectively. The indirect effect value of health knowledge and concepts on healthy lifestyle and behavior was 0.224. Conclusion Improving the residents' health knowledge and concepts through conducting health education is one of the effective ways to increase their health literacylevels. Currently, we should focus on improving the basic healthknowledge and concepts of people with low level of education, low income, and advanced age. In addition, training health skills is an effective way to address the issue of separation between knowledge and practice.
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2024, Vol. 31 
