The Construction Level of Health Literate Health Organizations and Its Impact on Patients’ Health Literacy: Based on Self-Determination Theory and Structural Equation Modeling
This study aims to develop a scale for patient evaluation of health literate health care organizations (PEHLHO) tailored to the Chinese context, addressing deficiencies in existing tools. It also examines the relationships between PEHLHO, communicative health literacy (CHL), and enhancement of perce...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-07-01
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| Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| Online Access: | https://doi.org/10.1177/00469580251351178 |
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| author | Renjie Lu PhD Jing Zhou MD Jiaying Ge BD Xiyang Xia MD Chao Lei MD Shenyu Zhao BD Dan Shen BD Xiaoyu Wang MD Jiaqian Chang BD Yang Chen MD Lingmin Hu PhD |
| author_facet | Renjie Lu PhD Jing Zhou MD Jiaying Ge BD Xiyang Xia MD Chao Lei MD Shenyu Zhao BD Dan Shen BD Xiaoyu Wang MD Jiaqian Chang BD Yang Chen MD Lingmin Hu PhD |
| author_sort | Renjie Lu PhD |
| collection | DOAJ |
| description | This study aims to develop a scale for patient evaluation of health literate health care organizations (PEHLHO) tailored to the Chinese context, addressing deficiencies in existing tools. It also examines the relationships between PEHLHO, communicative health literacy (CHL), and enhancement of perceived health literacy (EPHL) in major Chinese cities. This includes their correlation with perceived service quality (PSQ) and perceived a community with shared future for doctor-patient (PCSF) to improve healthcare service quality and patient experiences in China. A PEHLHO Scale was developed using focus group discussions and the Delphi method, with other scales adapted from existing instruments. This cross-sectional study was conducted through an online survey administered in major cities from February 17, 2024, to March 4, 2024, which included Shanghai, Chengdu, Guangzhou, Beijing, Wuhan, Xuzhou, Nanjing, Suzhou across China. A total of 6411 questionnaires were collected. Following quality control standards, the remaining sample of 5206 valid responses met the minimum recommended size for structural equation modeling. Data analysis was performed using SPSS and AMOS software. Exploratory factor analysis of the PEHLHO Scale revealed 3 factors: health education, involvement in diagnosis and treatment, and convenient services. All scales showed good validity and reliability. Informing patients about service fees received the lowest score. A Structural-Process-Outcome model confirmed that PEHLHO positively influences PCSF and PSQ, with CHL and EPHL as mediators. This model was validated in additional cities, demonstrating good generalizability. Enhancing patient health literacy should focus on systemic changes. Establishing health literate health organizations (HLHOs) can improve CHL, doctor-patient communication, and patient health literacy, ultimately optimizing healthcare service quality and doctor-patient relationships. Promoting (HLHOs) in China has significant potential and importance. |
| format | Article |
| id | doaj-art-ea9e23ec0bfb44169fdecd7c97ae0b51 |
| institution | Matheson Library |
| issn | 0046-9580 1945-7243 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| spelling | doaj-art-ea9e23ec0bfb44169fdecd7c97ae0b512025-07-21T06:03:37ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432025-07-016210.1177/00469580251351178The Construction Level of Health Literate Health Organizations and Its Impact on Patients’ Health Literacy: Based on Self-Determination Theory and Structural Equation ModelingRenjie Lu PhD0Jing Zhou MD1Jiaying Ge BD2Xiyang Xia MD3Chao Lei MD4Shenyu Zhao BD5Dan Shen BD6Xiaoyu Wang MD7Jiaqian Chang BD8Yang Chen MD9Lingmin Hu PhD10Changzhou Institute for Advanced Study of Public Health, Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Reproduction, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Reproduction, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Reproduction, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaChangzhou Traditional Chinese Medicine Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaChangzhou Third People’s Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Reproduction, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Reproduction, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Reproduction, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Reproduction, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Reproduction, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, ChinaThis study aims to develop a scale for patient evaluation of health literate health care organizations (PEHLHO) tailored to the Chinese context, addressing deficiencies in existing tools. It also examines the relationships between PEHLHO, communicative health literacy (CHL), and enhancement of perceived health literacy (EPHL) in major Chinese cities. This includes their correlation with perceived service quality (PSQ) and perceived a community with shared future for doctor-patient (PCSF) to improve healthcare service quality and patient experiences in China. A PEHLHO Scale was developed using focus group discussions and the Delphi method, with other scales adapted from existing instruments. This cross-sectional study was conducted through an online survey administered in major cities from February 17, 2024, to March 4, 2024, which included Shanghai, Chengdu, Guangzhou, Beijing, Wuhan, Xuzhou, Nanjing, Suzhou across China. A total of 6411 questionnaires were collected. Following quality control standards, the remaining sample of 5206 valid responses met the minimum recommended size for structural equation modeling. Data analysis was performed using SPSS and AMOS software. Exploratory factor analysis of the PEHLHO Scale revealed 3 factors: health education, involvement in diagnosis and treatment, and convenient services. All scales showed good validity and reliability. Informing patients about service fees received the lowest score. A Structural-Process-Outcome model confirmed that PEHLHO positively influences PCSF and PSQ, with CHL and EPHL as mediators. This model was validated in additional cities, demonstrating good generalizability. Enhancing patient health literacy should focus on systemic changes. Establishing health literate health organizations (HLHOs) can improve CHL, doctor-patient communication, and patient health literacy, ultimately optimizing healthcare service quality and doctor-patient relationships. Promoting (HLHOs) in China has significant potential and importance.https://doi.org/10.1177/00469580251351178 |
| spellingShingle | Renjie Lu PhD Jing Zhou MD Jiaying Ge BD Xiyang Xia MD Chao Lei MD Shenyu Zhao BD Dan Shen BD Xiaoyu Wang MD Jiaqian Chang BD Yang Chen MD Lingmin Hu PhD The Construction Level of Health Literate Health Organizations and Its Impact on Patients’ Health Literacy: Based on Self-Determination Theory and Structural Equation Modeling Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| title | The Construction Level of Health Literate Health Organizations and Its Impact on Patients’ Health Literacy: Based on Self-Determination Theory and Structural Equation Modeling |
| title_full | The Construction Level of Health Literate Health Organizations and Its Impact on Patients’ Health Literacy: Based on Self-Determination Theory and Structural Equation Modeling |
| title_fullStr | The Construction Level of Health Literate Health Organizations and Its Impact on Patients’ Health Literacy: Based on Self-Determination Theory and Structural Equation Modeling |
| title_full_unstemmed | The Construction Level of Health Literate Health Organizations and Its Impact on Patients’ Health Literacy: Based on Self-Determination Theory and Structural Equation Modeling |
| title_short | The Construction Level of Health Literate Health Organizations and Its Impact on Patients’ Health Literacy: Based on Self-Determination Theory and Structural Equation Modeling |
| title_sort | construction level of health literate health organizations and its impact on patients health literacy based on self determination theory and structural equation modeling |
| url | https://doi.org/10.1177/00469580251351178 |
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