To explore the health literacy about infection disease prevention and treatment in residents of Taizhou, Zhejiang during 2017—2020, and to analyze the trend of changes as well as influencing factors, providing scientific evidence for the precise implementation of actions for achieving "Healthy Taizhou 2030".

This study was implemented from 2017 to 2020 with Taizhou permanent residents aged between 15 and 69 selected using multistage random sampling, for investigating their demographics, socioeconomic features and health literacy about infection disease prevention and treatment using the National Residents' Health Literacy Monitoring Questionnaire developed by us. In January 2021, the data of health literacy about infection disease prevention and treatment of residents in Taizhou City in four years was analyzed. The health literacy data during 2017—2020 were comparatively analyzed after being processed with weight standardization, and the trend of changes during the period was analyzed using a Chi-squared test for linear trend. Binary logistic regression was used for identifying factors associated with relevant health literacy of these residents in 2020.

The number of respondents for the survey conducted in four consecutive years from 2017 to 2020, was 3 595, 5 389, 5 929, and 5 847, respectively. The samples in the four yearly surveys showed basically similar demographics, with those aged 45-54 (27.42%-30.46%) , education level was junior high school (27.78%-29.93%) , occupation was farmer (44.52%-58.03%) accounting for the largest proportion. The urban to rural population ratio for the sample of four consecutive yearly surveys was 0.50∶1, 0.55∶1, 0.54∶1 and 0.52∶1, respectively. And the male to female ratio was 1∶1, 0.95∶1, 0.99∶1 and 0.94∶1, respectively. The prevalence of having health literacy about infection disease prevention and treatment for 2017—2020 was 7.86% (642/3 595) , 19.00% (1 024/5 389) , 19.51% (1 157/5 929) , and 27.14% (1 587/5 847) , respectively. After the data were processed with weight standardization, the prevalence of health literacy regarding infectious disease prevention and treatment in 15-69-year-old residents in 2017—2020 was 22.25%, 24.72%, 25.34% and 33.14%, respectively. The health literary level regarding infectious disease prevention and treatment in the residents showed a successive linear increment during the study period regardless of living in rural or urban areas, sex, age (except for 65-69 year olds) , and education level (except for illiteracy/lower illiteracy) , and occupation (P<0.05) . Multivariate Logistic regression analysis showed that gender, age, education level, out-of-pocket health care costs in the past year, and annual household income were associated with health literacy regarding infectious disease prevention and treatment (P<0.05) .

Our analysis indicates that some advances in prevention and control as well as health education regarding infectious diseases have been achieved in Taizhou, but there is still much room for improvement. In the "golden window" period for normalized prevention and control of COVID-19, it is suggested that Taizhou should strengthen health education regarding infectious disease prevention and treatment for key groups, such as those who are middle-aged and elderly, lower educated, or engage in a career as a farmer or worker, to further improve relevant heath literacy of Taizhou residents.

了解2017—2020年浙江省台州市居民传染病防治素养水平和变化趋势，分析影响台州市居民传染病防治素养水平的因素，为"健康台州行动"精准施策提供科学依据。

采用多阶段随机抽样法，2017—2020年抽取台州市15~69岁常住人口为调查对象，采用"全国居民健康素养监测调查问卷"对其传染病防治素养水平进行调查，同时对其一般人口学特征、社会经济地位等方面的资料进行采集。于2021年1月对连续4年台州市居民传染病防治素养水平数据进行分析。在对2017—2020年台州市居民传染病防治素养水平进行分析和比较前，先对数据进行加权标化。采用趋势性χ²检验分析不同特征居民传染病防治素养具备情况随时间推移的变化趋势，采用二元Logistic回归对影响2020年台州市居民传染病防治素养水平的因素进行分析。

2017—2020年台州市居民健康素养监测调查分别收回有效问卷3 595、5 389、5 929、5 847份。四次调查样本一般人口学特征基本保持一致，城乡人口比例分别约为0.50∶1、0.55∶1、0.54∶1、0.52∶1；男女性别比例分别约为1∶1、0.95∶1、0.99∶1、0.94∶1；45~54岁年龄段、文化程度为初中、职业类型为农民的调查对象所占比例最高，分别达到27.42%~30.46%、27.78%~29.93%、44.52%~58.03%。四次调查中，具备传染病防治素养的居民分别占调查人数的17.86%（642/3 595）、19.00%（1 024/5 389）、19.51%（1 157/5 929）、27.14%（1 587/5 847）。2017—2020年台州市15~69岁居民传染病防治素养水平分别为22.25%、24.72%、25.34%、33.14%。不同居住地、性别、年龄组别（除65~69岁组）、文化程度（除不识字/少识字）和职业居民的传染病防治素养具备率随时间推移呈升高趋势（P<0.05）。二元Logistic回归分析结果显示，性别、年龄、文化程度、过去1年自付医药费用和家庭年收入是台州市居民传染病防治素养水平的影响因素（P<0.05）。

2017—2020年台州市传染病防控及健康教育工作取得一定成效，但工作开展水平仍有较大的提升空间。台州市应抓住新型冠状病毒肺炎疫情常态化防控背景下的"黄金窗口期"，进一步加强对中老年人、低文化程度者、农民及工人等重点群体的健康教育工作，继续大力提升居民的传染病防治素养。