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

摘要： 背景　相较于西方居民从成熟的社区建设中通过各种联系获得资源，中国居民更多从家庭的联系中获得健康资源。因此，探究家庭社会资本通过健康素养影响健康的机制对于建立以“家庭为中心”的健康教育模式有一定的研究意义。目的　通过对杭州市居民的家庭社会资本、健康素养和健康状况的调查，探究家庭社会资本通过健康素养对健康状况的影响，为社区健康教育与健康促进提供政策参考依据。方法　于2020年1月，采用多阶段分层随机抽样法选取900例杭州市居民作为研究对象，采用自编量表对其进行问卷调查，问卷内容包括家庭社会资本、健康素养、健康状况和一般人口学特征四部分。运用Cronbach's α系数评价家庭社会资本问卷信度，因子分析法评价家庭社会资本问卷效度；运用结构方程模型路径分析家庭社会资本通过健康素养对健康状况的作用机制及影响效应。结果　共发放问卷900份，回收有效问卷848份，回收有效率为94.2%。经检验，家庭社会资本量表总体Cronbach's α系数达到0.826，旋转因子载荷图中各条目在对应维度上的因子载荷均>0.5。在健康素养的5个维度中，家庭社会资本对健康生活方式的直接影响最大（0.63）。在家庭社会资本通过健康素养对健康状况影响的途径中，通过卫生服务利用影响健康状况的间接效应值最大（0.14），其次是健康生活方式（0.12），通过健康理念对健康状况的影响最小（0.07）。结论　家庭社会资本通过健康素养对健康状况的影响作用存在（直接和间接的）路径差异，提示在针对家庭健康教育制定相关卫生政策及社会干预措施时，要考虑该影响并釆取差异化的措施。

关键词: 家庭社会资本, 健康素养, 健康状况, 路径分析, 杭州