Exploring the Link between Family Health and Health Literacy among College Students: The Mediating Role of Psychological Resilience
Abstract
:1. Introduction
2. Materials and Methods
2.1. Procedures and Participants
2.2. Measures
2.3. Statistical Analysis
3. Results
3.1. Results of Descriptive Statistics
3.2. Correlation Test between Variables
3.3. Regression Analysis Results and Mediating Effect Test
4. Discussion
5. Implications and Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Prest, L.A.; Protinsky, H. Family systems theory: A unifying framework for codependence. Am. J. Fam. Ther. 1993, 21, 352–360. [Google Scholar] [CrossRef]
- Kickbusch, I.S. Health literacy: Addressing the health and education divide. Health Promot. Int. 2001, 16, 289–297. [Google Scholar] [CrossRef]
- Ickes, M.J.; Cottrell, R. Health literacy in college students. J. Am. Coll. Health 2010, 58, 491–498. [Google Scholar] [CrossRef] [PubMed]
- Ye, Y.L.; Wang, P.G.; Qu, G.C.; Yuan, S.; Phongsavan, P.; He, Q.Q. Associations between multiple health risk behaviors and mental health among Chinese college students. Psychol. Health Med. 2016, 21, 377–385. [Google Scholar] [CrossRef] [PubMed]
- Rizhao Sports Bureau. 2020 China University Student Health Survey Report Released. 2020. Available online: https://www.thepaper.cn/newsDetail_forward_5489171 (accessed on 27 May 2023).
- Huang, J.; Zheng, M.; Du, G.; Wei, P.; Shen, X.; Jin, J.; Jin, H. Influence of contest on Chinese college students’ health literacy based on repeated cross-sectional studies. J. Am. Coll. Health 2022, 70, 1500–1507. [Google Scholar] [CrossRef]
- Rababah, J.A.; Al-Hammouri, M.M.; Drew, B.L. The impact of health literacy on college students’ psychological disturbances and quality of life: A structural equation modeling analysis. Health Qual. Life Outcomes 2020, 18, 292. [Google Scholar] [CrossRef] [PubMed]
- Kanj, M.; Mitic, W. Health literacy and health promotion: Definitions, concepts and examples in the Eastern Mediterranean region. In Proceedings of the 7th Global Conference on Health Promotion Promoting Health and Development: Closing the Implementation Gap, Nairobi, Kenya, 26–30 October 2009; pp. 26–30. [Google Scholar]
- Chari, R.; Warsh, J.; Ketterer, T.; Hossain, J.; Sharif, I. Association between health literacy and child and adolescent obesity. Patient Educ. Couns. 2014, 94, 61–66. [Google Scholar] [CrossRef]
- Lloyd, T.; Shaffer, M.L.; Stetter, C.; Widome, M.D.; Repke, J.; Weitekamp, M.R.; Paul, I.M. Health knowledge among the millennial generation. J. Public Health Res. 2013, 2, jphr-2013. [Google Scholar] [CrossRef] [Green Version]
- Ratzan, S.; Parker, R.M. National Library of Medicine Current Bibliographies in Medicine: Health Literacy; National Institutes of Health, U.S. Department of Health and Human Services: Bethesda, MD, USA, 2000; pp. 331–337.
- Nutbeam, D.; Kickbusch, I. Advancing health literacy: A global challenge for the 21st century. Health Promot. Int. 2000, 15, 183–184. [Google Scholar] [CrossRef]
- McCray, A.T. Promoting health literacy. J. Am. Med. Inform. Assoc. 2005, 12, 152–163. [Google Scholar] [CrossRef] [Green Version]
- Shi, Y.; Ma, D.; Zhang, J.; Chen, B. In the digital age: A systematic literature review of the e-health literacy and influencing factors among Chinese older adults. J. Public Health 2021, 31, 679–687. [Google Scholar] [CrossRef]
- Van Der Heide, I.; Wang, J.; Droomers, M.; Spreeuwenberg, P.; Rademakers, J.; Uiters, E. The relationship between health, education, and health literacy: Results from the Dutch Adult Literacy and Life Skills Survey. J. Health Commun. 2013, 18 (Suppl. S1), 172–184. [Google Scholar] [CrossRef] [Green Version]
- Liu, Y.B.; Liu, L.; Li, Y.F.; Chen, Y.L. Relationship between health literacy, health-related behaviors and health status: A survey of elderly Chinese. Int. J. Environ. Res. Public Health 2015, 12, 9714–9725. [Google Scholar] [CrossRef] [Green Version]
- Ross, W.; Culbert, A.; Gasper, C.; Kimmey, J. A Theory-Based Approach to Improving Health Literacy; Missouri Health Foundation: St. Louis, MO, USA, 2009. [Google Scholar]
- Nutbeam, D.; McGill, B.; Premkumar, P. Improving health literacy in community populations: A review of progress. Health Promot. Int. 2018, 33, 901–911. [Google Scholar] [CrossRef]
- Mayberry, L.S.; Kripalani, S.; Rothman, R.L.; Osborn, C.Y. Bridging the digital divide in diabetes: Family support and implications for health literacy. Diabetes Technol. Ther. 2011, 13, 1005–1012. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rothbaum, F.; Rosen, K.; Ujiie, T.; Uchida, N. Family systems theory, attachment theory, and culture. Fam. Process 2002, 41, 328–350. [Google Scholar] [CrossRef]
- Chen, Y.F.; Katz, J.E. Extending family to school life: College students’ use of the mobile phone. Int. J. Hum.-Comput. Stud. 2009, 67, 179–191. [Google Scholar] [CrossRef]
- Wang, D.; Sun, X.; He, F.; Liu, C.; Wu, Y. The mediating effect of family health on the relationship between health literacy and mental health: A national cross-sectional survey in China. Int. J. Soc. Psychiatry 2023. [Google Scholar] [CrossRef] [PubMed]
- Liu, L.; Qian, X.; Chen, Z.; He, T. Health literacy and its effect on chronic disease prevention: Evidence from China’s data. BMC Public Health 2020, 20, 690. [Google Scholar] [CrossRef]
- Crandall, A.; Weiss-Laxer, N.S.; Broadbent, E.; Holmes, E.K.; Magnusson, B.M.; Okano, L.; Novilla, L.B. The family health scale: Reliability and validity of a short-and long-form. Front. Public Health 2020, 8, 587125. [Google Scholar] [CrossRef] [PubMed]
- Ishikawa, H.; Kiuchi, T. Association of health literacy levels between family members. Front. Public Health 2019, 7, 169. [Google Scholar] [CrossRef] [Green Version]
- Wong, J.Y.H.; Wai, A.K.C.; Zhao, S.; Yip, F.; Lee, J.J.; Wong, C.K.H.; Lam, T.H. Association of individual health literacy with preventive behaviours and family well-being during COVID-19 pandemic: Mediating role of family information sharing. Int. J. Environ. Res. Public Health 2020, 17, 8838. [Google Scholar] [CrossRef]
- Chen, F.; Fan, W.; Li, Y. Influence of psychological supervision on athletes’ compliance, mental elasticity characteristics and acute stress disorder in traumatic fracture rehabilitation training. Iran. J. Public Health 2022, 51, 133. [Google Scholar] [CrossRef] [PubMed]
- Yan, Y. Occurrence and high risk factors of post-traumatic stress disorder related to orthopedic surgery. Chin. J. Tissue Eng. Res. 2020, 3897–3903. [Google Scholar]
- Xu, Y.; Lin, X.; Chen, S.; Liu, Y.; Liu, H. Ageism, resilience, coping, family support, and quality of life among older people living with HIV/AIDS in Nanning, China. Glob. Public Health 2018, 13, 612–625. [Google Scholar] [CrossRef] [PubMed]
- Killgore, W.D.; Taylor, E.C.; Cloonan, S.A.; Dailey, N.S. Psychological resilience during the COVID-19 lockdown. Psychiatry Res. 2020, 291, 113216. [Google Scholar] [CrossRef] [PubMed]
- Zhang, J.Y.; Ji, X.Z.; Zhou, Y.Q. The Mediating Effect of Mental Health Literacy on Psychological Resilience and Psychological Distress of Medical College Students. Perspect. Psychiatr. Care 2023, 2023, 3461121. [Google Scholar] [CrossRef]
- Wu, Y.; Sun, X.; Wang, D.; Ming, W.K.; Sun, X.; Wu, Y. Reliability and validity of the Chinese version of a short form of the family health scale. BMC Fam. Pract. 2022, 23, 108. [Google Scholar]
- Connor, K.M.; Davidson, J.R. Development of a new resilience scale: The Connor-Davidson resilience scale (CD-RISC). Depress. Anxiety 2003, 18, 76–82. [Google Scholar] [CrossRef]
- Wang, L.; Shi, Z.; Zhang, Y.; Zhang, Z. Psychometric properties of the 10-item Connor–Davidson Resilience Scale in Chinese earthquake victims. Psychiatry Clin. Neurosci. 2010, 64, 499–504. [Google Scholar] [CrossRef]
- Duong, T.V.; Aringazina, A.; Kayupova, G.; Nurjanah, F.; Pham, T.V.; Pham, K.M. Development and validation of a new short-form health literacy instrument (Hls-Sf12) for the general public in six Asian countries. Health Lit. Res. Pract. 2019, 3, e91–e102. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sun, X.; Wu, Y.; Tang, J.; Wang, F.; Sun, X.; He, M. Development of a Short Version of the Health Literacy Scale Short-Form: Based on Classical Test Theory and Item Response Theory. 2022. Available online: https://chinaxiv.org/abs/202211.00133 (accessed on 21 November 2022).
- National Health Commission. National Health Literacy Level Rises to 23.15% by 2020. 2021. Available online: https://www.gov.cn/xinwen/2021-04/01/content_5597287.htm (accessed on 27 May 2023).
- Olson, D.H. Circumplex model of marital and family systems. J. Fam. Ther. 2000, 22, 144–167. [Google Scholar] [CrossRef]
- Javier, J.R.; Galura, K.; Aliganga, F.A.P.; Supan, J.; Palinkas, L.A. Voices of the Filipino community describing the importance of family in understanding adolescent behavioral health needs. Fam. Community Health 2018, 41, 64. [Google Scholar] [CrossRef] [PubMed]
- Crockett, L.J.; Iturbide, M.I.; Torres Stone, R.A.; McGinley, M.; Raffaelli, M.; Carlo, G. Acculturative stress, social support, and coping: Relations to psychological adjustment among Mexican American college students. Cult. Divers. Ethn. Minor. Psychol. 2007, 13, 347. [Google Scholar] [CrossRef] [Green Version]
- Allen, J.P.; Porter, M.; McFarland, C.; McElhaney, K.B.; Marsh, P. The relation of attachment security to adolescents’ paternal and peer relationships, depression, and externalizing behavior. Child Dev. 2007, 78, 1222–1239. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Thoits, P.A. Mechanisms linking social ties and support to physical and mental health. J. Health Soc. Behav. 2011, 52, 145–161. [Google Scholar] [CrossRef] [Green Version]
- Umberson, D.; Karas Montez, J. Social relationships and health: A flashpoint for health policy. J. Health Soc. Behav. 2010, 51 (Suppl. S1), S54–S66. [Google Scholar] [CrossRef] [Green Version]
- Chew, J.; Carpenter, J.; Haase, A.M. Young people’s experiences of living with epilepsy: The significance of family resilience. Soc. Work Health Care 2018, 57, 332–354. [Google Scholar] [CrossRef] [Green Version]
- Acuña, M.A.; Kataoka, S. Family communication styles and resilience among adolescents. Soc. Work 2017, 62, 261–269. [Google Scholar] [CrossRef]
Variables | M ± SD or n (%) | |
---|---|---|
Age | 20.53 ± 1.60 | |
Gender | ||
Male | 2189 (40.0) | |
Female | 3284 (60.0) | |
Place of residence | ||
Rural area | 2551 (46.6) | |
Town | 2922 (53.4) | |
Monthly per capita household income (CNY) | ||
≤1000 | 699 (12.8) | |
1001–2000 | 807 (14.7) | |
2001–3000 | 835 (15.3) | |
3001–4000 | 728 (13.3) | |
4001–5000 | 630 (11.5) | |
5001–6000 | 526 (9.6) | |
6001–9000 | 480 (8.8) | |
9001–12,000 | 341 (6.2) | |
12,001–15,000 | 159 (2.9) | |
≥15,000 | 268 (4.9) | |
Father’s highest education level | ||
No formal education | 181 (3.3) | |
Elementary school | 900 (16.4) | |
Junior high school | 1975 (36.1) | |
Junior college | 497 (9.1) | |
High school | 815 (14.9) | |
College | 539 (9.8) | |
Undergraduate | 483 (8.8) | |
Master | 40 (0.7) | |
PhD | 43 (0.8) | |
Mother’s highest education level | ||
No formal education | 274 (5.0) | |
Elementary school | 1119 (20.4) | |
Junior high school | 1914 (35.0) | |
Junior college | 520 (9.5) | |
High school | 646 (11.8) | |
College | 503 (9.2) | |
Undergraduate | 427 (7.8) | |
Master | 25 (0.5) | |
PhD | 45 (0.8) |
M (SD) | (1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) | |
---|---|---|---|---|---|---|---|---|---|---|
(1) | 20.53 (1.60) | 1 | ||||||||
(2) | 0.60 (0.49) | −0.040 ** | 1 | |||||||
(3) | 0.53 (0.50) | −0.078 *** | −0.056 *** | 1 | ||||||
(4) | 4.43 (2.55) | −0.127 *** | −0.097 *** | 0.303 *** | 1 | |||||
(5) | 3.89 (1.72) | −0.073 *** | −0.077 *** | 0.380 *** | 0.344 *** | 1 | ||||
(6) | 3.69 (1.73) | −0.102 *** | −0.060 *** | 0.413 *** | 0.331 *** | 0.671 *** | 1 | |||
(7) | 37.98 (6.81) | −0.160 *** | 0.169 *** | 0.064 *** | 0.152 *** | 0.094 *** | 0.096 *** | 1 | ||
(8) | 32.54 (8.05) | −0.037 *** | 0.036 *** | 0.049 *** | 0.080 *** | 0.076 *** | 0.090 *** | 0.395 *** | 1 | |
(9) | 24.28 (6.85) | −0.064 *** | 0.085 *** | 0.063 *** | 0.061 *** | 0.071 *** | 0.078 *** | 0.557 *** | 0.446 *** | 1 |
Regression (N = 5473) | Fitting Metrics | Coefficients and Significances | ||||
---|---|---|---|---|---|---|
Outcome variables | Predicting variables | R | R2 | F(df) | β | t |
Health literacy | 0.56 | 0.31 | 498.07 *** (7) | |||
Age | 0.03 | 2.27 * | ||||
Gender | −0.01 | −0.92 | ||||
Place of residence | 0.03 | 2.24 * | ||||
Monthly per capita household income | −0.04 | −3.29 ** | ||||
Father’s highest education level | 0.005 | 0.35 | ||||
Mother’s highest education level | 0.02 | 1.57 | ||||
Family health | 0.56 | 48.39 *** | ||||
Psychological resilience | 0.40 | 0.16 | 149.13 *** (7) | |||
Age | 0.03 | 2.51 * | ||||
Gender | −0.03 | −2.10 * | ||||
Place of residence | 0.002 | 0.12 | ||||
Monthly per capita household income | 0.002 | 0.17 | ||||
Father’s highest education level | 0.006 | 0.32 | ||||
Mother’s highest education level | 0.05 | 2.78 ** | ||||
Family health | 0.40 | 31.05 *** | ||||
Health literacy | 0.61 | 0.37 | 406.63 *** (8) | |||
Age | 0.02 | 1.60 | ||||
Gender | −0.003 | −0.31 | ||||
Place of residence | 0.03 | 2.30 * | ||||
Monthly per capita household income | −0.04 | −3.50 *** | ||||
Father’s highest education level | 0.004 | 0.27 | ||||
Mother’s highest education level | 0.01 | 0.79 | ||||
Family health | 0.46 | 37.92 *** | ||||
Psychological resilience | 0.27 | 22.79 *** |
Estimate | Bootstrap SE | Bootstrap 95% CI | Effect Ratio | ||
---|---|---|---|---|---|
Lower | Upper | ||||
Total Effect | 0.56 | 0.01 | 0.55 | 0.59 | - |
Direct Effect | 0.46 | 0.01 | 0.44 | 0.48 | 81.67% |
Mediating Effect | 0.11 | 0.01 | 0.09 | 0.13 | 18.93% |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Wang, Y.-Y.; Huang, X.-C.; Yuan, J.; Wu, Y.-B. Exploring the Link between Family Health and Health Literacy among College Students: The Mediating Role of Psychological Resilience. Healthcare 2023, 11, 1859. https://doi.org/10.3390/healthcare11131859
Wang Y-Y, Huang X-C, Yuan J, Wu Y-B. Exploring the Link between Family Health and Health Literacy among College Students: The Mediating Role of Psychological Resilience. Healthcare. 2023; 11(13):1859. https://doi.org/10.3390/healthcare11131859
Chicago/Turabian StyleWang, Yan-Yan, Xin-Cheng Huang, Jie Yuan, and Yi-Bo Wu. 2023. "Exploring the Link between Family Health and Health Literacy among College Students: The Mediating Role of Psychological Resilience" Healthcare 11, no. 13: 1859. https://doi.org/10.3390/healthcare11131859
APA StyleWang, Y.-Y., Huang, X.-C., Yuan, J., & Wu, Y.-B. (2023). Exploring the Link between Family Health and Health Literacy among College Students: The Mediating Role of Psychological Resilience. Healthcare, 11(13), 1859. https://doi.org/10.3390/healthcare11131859