摘要： 背景 《"健康中國2030"規(guī)劃綱要》提出：健全覆蓋全國的健康素養(yǎng)和生活方式監(jiān)測體系，強化個人健康責(zé)任，提高居民自我健康管理能力和健康水平，提高全民健康素養(yǎng)水平?？茖W(xué)的健康素養(yǎng)測評工具可以系統(tǒng)地了解居民健康素養(yǎng)水平并提供針對性的干預(yù)措施。我國的健康素養(yǎng)測評研究起步較晚，現(xiàn)有健康素養(yǎng)測評工具《中國公民健康素養(yǎng)-基本知識與技能（試行）》的評估內(nèi)容尚存在較大完善空間，因此研發(fā)有效、可靠的健康素養(yǎng)評價工具至關(guān)重要。 目的 基于主動健康視角，對國內(nèi)外健康素養(yǎng)評價工具相關(guān)文獻進行綜述。 方法 于2021年7月，以"Health Literacy" "Tool" "Evaluation" "Assessment" "Questionnaire" "Scale" "健康素養(yǎng)" "工具" "測評" "評價" "問卷" "量表"等為中/英文關(guān)鍵詞，系統(tǒng)檢索PubMed、Web of Science、中國知網(wǎng)、萬方數(shù)據(jù)知識服務(wù)平臺、維普數(shù)據(jù)庫，以獲取健康素養(yǎng)測評工具相關(guān)文獻，檢索時限為1990-01-01至2021-06-30，對健康素養(yǎng)測評工具的現(xiàn)狀及內(nèi)容進行綜述。 結(jié)果 共篩選出47種健康素養(yǎng)測評工具，包含27個客觀測評工具和20個主觀測評工具。研發(fā)和應(yīng)用最多的是美國（22個），其次是歐洲地區(qū)（13個）。語言方面，英語最多（25個），其次是葡萄牙語（5個）、意大利語（3個）、西班牙語（2個）。測評所需時間方面，成人醫(yī)學(xué)語言閱讀能力簡化快速測試量表（REALM-SF）、單問題健康素養(yǎng)篩查量表（SILS）用時最短（1 min），漢語健康素養(yǎng)測試量表（MHLS）用時最長（25 min）。測評條目最少的是SILS（1條），最多的是完整版成人醫(yī)學(xué)語言閱讀能力測試量表（REALM）（125條）?？陀^測評工具中被廣泛應(yīng)用的是成人醫(yī)學(xué)語言閱讀能力測試量表系列量表（REALM Family）與成人功能性健康素養(yǎng)測試量表系列量表（TOFHLA Family），主觀測評工具中被廣泛應(yīng)用的是歐洲健康素養(yǎng)調(diào)查問卷（HLS-EU-Q）。測評內(nèi)容主要涉及閱讀理解、計算能力、信息獲取、信息應(yīng)用、信息交流、詞匯識別等方面。 結(jié)論 在健康素養(yǎng)測評工具的研發(fā)和應(yīng)用中，歐美國家占據(jù)主導(dǎo)地位，客觀健康素養(yǎng)測評工具數(shù)量居多，隨著健康素養(yǎng)的內(nèi)涵從單一的個人評價轉(zhuǎn)變?yōu)閭€人與外部環(huán)境的綜合評價，我國健康素養(yǎng)測評工具的研發(fā)提倡以健康素養(yǎng)內(nèi)涵深化和主動健康理念為前提，全國建立統(tǒng)一標(biāo)準(zhǔn)，指標(biāo)以定量或半定量指標(biāo)為主，開發(fā)出涵蓋整個生命周期的適合我國國情的健康素養(yǎng)評價工具，從而為提升居民健康素養(yǎng)提供科學(xué)、有效的支持。

關(guān)鍵詞: 健康素養(yǎng), 測評工具, 主動健康, 系統(tǒng)評價

Abstract:

Background

The Outline of the "Healthy China 2030" Plan points out improve the health literacy and lifestyle monitoring system covering the whole country, strengthen personal health responsibility, improve residents' self-health management ability and health level, in order to greatly improve the level of national health literacy. Scientific health literacy assessment tools can systematically understand the health literacy level of residents and provide targeted interventions. The health literacy assessment started late in China. The content of existing health literacy assessment tool should been improved, which is called Chinese Citizens' Health Literacy-Trial Implementation of Basic Knowledge and Skills (to try out), because it is definitely important to create an effective and reliable health literacy assessment tool.

Objective

Based on the perspective of active health, this paper reviews the relevant literature on health literacy assessment tools at home and abroad.

Methods

Chinese and foreign databases of PubMed, Web of Science, CNKI, Wanfang and VIP were systematically retrieved using keywords including "Health literacy" "Tool""Evaluation" "Assessment" "Questionnaire" "Scale". The related literature of health literacy assessment tools was obtained with the retrieval time from 1990-01-01 to 2021-06-30, and the current situation and contents of health literacy assessment tools were reviewed.

Results

A total of 47 health literacy assessment tools were screened, including 27 objective assessment tools and 20 subjective assessment tools. The most of research and development (R&D) and application is in the United States (22) , followed by Europe (13) . The number of English tools is the largest (25) , followed by Portuguese (5) , Italian (3) and Spanish (2) . The evaluation time of REALM-SF, SILS is the shortest (1 minute) , and the longest for MHLS (25 minutes) . The least item is in SILS (1 item) , and REALM (125 items) has the most evaluated items. The most widely used evaluation tools are the REALM series scale and TOFHLA series scale in objective evaluation tools, and the HLS-EU-Q series scale in subjective evaluation tools. The evaluation mainly content involves vocabulary recognition, information acquisition, computing ability, reading comprehension, information exchange, information application and so on.

Conclusion

The development and application of health literacy assessment tools are dominated by European and American countries, and the number of objective health literacy assessment tools is in the majority. As the change of the connotation of health literacy from a single personal assessment to a comprehensive assessment of individuals and external environment, the R&D of health literacy assessment tools in China should be based on the establishment of unified standards across the country on the premise of deepening the connotation of health literacy and the concept of active health, the indicators should mainly be quantitative or semi quantitative indicators. A health literacy assessment tool suitable for China's national conditions covering the whole life cycle should be developed to provide scientific and effective support for improving the health literacy level of residents.

Key words: Health literacy, Assessment tools, Active health, Systematic reviews

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