关键词: 家庭社会资本, 健康素养, 健康状况, 路径分析, 杭州

Abstract: Background　In contrast to western people who often access to health resources in the mature community，Chinese people are more prone to acquiring health resources via family connections. So studying the mechanism of action of family social capital affecting health mediated by health literacy has a meaning for establishing a family-centered health education pattern. Objective　To explore the impact of family social capital on health status mediated by health literacy by analyzing the survey data from Hangzhou residents，providing a reference for policy-making regarding community health education and promotion. Methods　900 Hangzhou residents were selected by multi-stage stratified random sampling method and investigated by self-designed questionnaire. The questionnaire includes four parts：family social capital, health literacy，health status and general demographic characteristics. The Cronbach's α was used to evaluate the reliability of the family social capital subscale，and factor analysis was used to evaluate its validity. Structural equation modeling was used to model the paths of health literacy mediating the impact of family social capital on self-rated health and to quantify the effect size. Results　In total，848（94.2%） of the 900 residents returned responsive questionnaires. The Cronbach's α for the family social capital subscale was tested to be as high as 0.826，and the factor loading of each item in the corresponding domain in the rotation factor loading diagram was greater than 0.5. The results of the structural equation model show that all fitting indicators were within an acceptable range，illustrating that the model fitted well. Among the five domains of health literacy subscale，healthy lifestyle was influenced most directly by family social capital（0.63）. Among the paths for family social capital affecting health status mediated by health literacy，the effect size of the indirect effect of healthcare utilization was the largest（0.14），followed by healthy lifestyle（0.12），while that of health concepts was the smallest（0.07）. Conclusion　The effect size of family social capital affecting health status mediated by health literacy may be varied by paths（direct and indirect），which is suggested to be considered accordingly when formulating health policies and social intervention programs for family health education.

Key words: Family social capital, Health literacy, Health status, Path analysis, Hangzhou