Research progress on adolescent health literacy assessment tools
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摘要: 青少年健康素养是促进其健康问题应对、健康行为养成的最根本、最经济且最有效的策略，而健康素养测评有助于了解青少年健康素养水平。研究系统梳理了国内外现有测评工具，并从构成性、适用性与科学性三个方面展开分析，进一步探讨其未来发展趋势，旨在为完善青少年健康素养测评工具功能提供理论依据和实践指导，以更好地满足青少年健康需求。Abstract: Adolescent health literacy constitutes a fundamental, economical and effective strategy for addressing their health issues and fostering healthy behaviors, while assessing health literacy plays a pivotal role in evaluating adolescents' health literacy. The study systematically reviews existing adolescent health literacy assessment tools at both domestically and internationally, and analyzes them through three dimensions: structural components, applicability and scientific validity. It further examines emerging trends in the development of such tools, aiming to offer theoretical underpinnings and practical recommendations for their refinement, thereby more effectively addressing the evolving health needs of adolescents.
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Key words:
- Health education /
- Tool use behavior /
- Adolescent /
- Health promotion
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 青少年健康素养测评工具特征列表
Table 1. List of characteristics of adolescent health literacy assessment tools
序号 工具名称 构成性 适用性 科学性 内容及条目数 题型 对象 场景 时长 类型 信度系数 局限 1 REALM-Teen[17] 按难度排列的66个词汇 单词识别 10~19岁 临床 2.5 min 客观 T=0.94 仅测词汇识别；文化适应性不足 2 REALM-TeenS[19] 按难度排列的10个词汇 单词识别 10~19岁 临床 20 s 客观 T=0.82 词汇代表性、文化适应性不足 3 NVS-PTeen[20] 冰淇淋标签6个 阅读理解、数值计算 八至十二年级/12~17岁 学校 6 min 客观 K=0.61 样本单一；缺乏青少年文化适配 4 HAS-A[21] 3个分量表：功能性、互动性、批判性，4个领域：获取、交流、理解、处理，共62题 量表题 12~19岁 临床/学校 — 主观 T=0.78
D=0.73~0.77样本代表性不足；维度覆盖有限 5 HLSAC[23] 5个维度：理论知识、实践知识、批判性思维、自我意识、公民意识，10题 量表题 七至九年级/
13~15岁学校 — 主观 T=0.93 年龄适用有限；题项设计需优化 6 AAHL[22] 3个维度：功能性、互动性、批判性，23题 图表解读、阅读理解、数值计算、多选题等 12~18岁 学校 — 客观 K=0.63/0.74/0.74 样本代表性不足；公平性待验证 7 HELMA[24] 8个维度：信息获取、阅读、理解、评估、使用、交流、自我效能、计算能力，44题 量表题 15~18岁 学校 15 min 主观 T=0.93 不同年龄和环境待验证 8 MOHLAA-Q[25] 4个维度：健康信息处理、沟通与互动技能、健康态度、健康知识，29题 量表题、判断题 14~17岁 学校/
公共卫生— 主观 D=0.54~0.77 结构效度与一致性不足；样本代表性不足 9 AHLQ[26] 6个维度：健康知识，优质健康信息的来源，促进因素与障碍，他人影响，自我效能、自我管理与复原力，公民意识与沟通，41题 情境题、量表题 12~18岁 学校 — 主观 — 样本偏倚；样本量有限 10 中国青少年互动性健康素养评定问卷[34] 6个维度：健康意识、体力活动、人际关系、压力管理、精神成长、营养，31题 量表题 初中生+高中生 学校 — 主观 T=0.94
D≥0.70样本区域有限，代表性不足 11 青少年健康素养与健康状况调查问卷[35] 3个维度：基本知识和理念、健康生活方式与行为、基本技能，71题 选择题 小学生+初中生/
(13.2±1.2)岁学校 20 min 主观 T=0.70
D=0.68~0.72作答形式单一；对象覆盖有限 12 中学生健康素养量表[41] 5个维度：健康理念、基本健康知识、健康生活方式与行为、健康认知技能、操作技能，31题 判断题、单选题、多选题、情境模拟题 六年级+初中生+
高中生/11~19岁学校 — 主/
客观T=0.74
D=0.54~0.68自填影响客观性；一致性偏低 13 初中生健康素养量表[36] 3个维度：功能性、互动性、评判性，9个因子：科学健康观、营养饮食、疾病预防、青春期发育、心理健康、意外伤害与急救、问题解决能力、健康决定能力、健康评判能力，共50题 量表题 初中生/(13.95±
1.54)岁学校 — 主观 T=0.95 D=0.86~0.95 样本局限于单校 14 中小学生健康素养评价工具[40] 小学、初中、高中各4个一级维度：健康知识、健康理念、健康技能、健康行为，分别有71，78，70个条目 — 小学生+初中生+高中生 学校 — 主/
客观T≥0.70 题目难度与区分度低；适用范围待完善 15 中学生健康素养问卷[42] 3个分量表：珍爱生命、健全人格和自我管理，10个子维度：生命意义、网络健康行为、健康生活方式、青春期健康知识、自尊自信、自立自强、感恩、自我激励与时间管理、未来生涯规划、社会自我认识，共37题 量表题 初中生+高中生/
(14.11±1.56)岁学校 — 主观 T=0.92
D=0.70/0.86/0.87样本量不足；缺乏线上监测系统 16 中国初中生综合健康素养测评问卷[37] 4个维度：健康知识、健康技能、健康动机、健康相关行为，57题 判断题、选择题、量表题 初中生 学校 — 主/
客观T=0.82
D=0.77/0.68需结合政策动态修订；验证不足 17 中国高中生健康素养评价量表[38] 横向维度：健康行为与生活方式、生长发育与青春期保健、心理健康、传染病预防与突发公共卫生事件应对、安全应急与避险，纵向维度：知识、态度、技能、行为，共39题 单选题、多选题、量表题 高中生 学校 20 min 主/
客观T=0.91 缺全国代表性；题目设计与难度需优化 注： T为总量表Cronbach α系数，D为维度量表Cronbach α系数，K为KR-20信度系数。 
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