Knowledge of Child Health and Affecting Factors Among Preschool Teachers: A Cross-Sectional Study in Chongqing, China

A new health literacy scale for staff in preschool childcare institution: development and preliminary validation

BACKGROUND

The health literacy of staff in preschool childcare institution is an important issue to consider in providing healthcare for children aged 3-6 years, which could contribute to reducing incidence of diseases and accidental injuries as well as maintaining children's good health. Seldom instruments have been designed to measure health literacy across this group. This research aims to develop a health literacy scale for staff in preschool childcare institutions and validate its psychometric properties.

METHODS

The scale was developed through four phases. In Phase 1, an item pool was developed mainly based on literature review and kindergarten work; In Phase 2, the initial items were reviewed by fifteen experts and content validity analysis was conducted; In Phase 3, a pilot study was conducted involving 30 kindergarten staff, which aimed to further modify the scale; In Phase 4, a psychometric validation study involving 466 kindergarten staff was conducted through a cross-sectional survey in May 2023. Item analysis was performed through critical ration, correlation analysis, and Cronbach's alpha if item deleted. Construct validity was performed through exploratory (n = 190) and confirmatory factor analyses (n = 276). Convergent and discriminant validity were evaluated. Reliability was evaluated through internal consistency, split-half reliability, and test-retest reliability.

RESULTS

The final Health Literacy Scale consisted of 28 items, including dimensions of Basic Health Knowledge (11 items), Functional Health Literacy Skills (3 items), Communicative Health Literacy (5 items), and Critical Health Literacy (9 items). Principal component analysis revealed a four-factor structure that explained 80.092% of the total variance. The goodness-of-fit indices signified an adequate model fit (χ2/df = 2.093, RMSEA = 0.063, RMR = 0.031, GFI = 0.852, CFI = 0.958, NFI = 0.923, IFI = 0.958, TLI = 0.953, PCFI = 0.844). Cronbach's alpha showed a good internal consistency reaching a value of 0.921. The split-half reliability was 0.805, and the test-retest reliability was good with an intraclass correlation coefficient of 0.885 (P < 0.001).

CONCLUSIONS

The Health Literacy Scale developed in this research focuses on health literacy issues related to children aged 3-6 years. The scale is demonstrated to be valid and reliable for assessing the health literacy of staff in preschool childcare institutions. It could potentially be used as an effective instrument for targeted development of health literacy intervention.

COVID-19 outbreak and increased risk of amblyopia and epidemic myopia: Insights from EUROCOVCAT group

The most common cause of vision impairment in children is amblyopia. It is defined as impaired visual acuity in one or both eyes that is present with no demonstrable abnormality of the visual pathway and is not immediately resolved by wearing glasses. After the World Health Organization (WHO) recognized COVID-19 as a global pandemic on March 11, 2020, widespread changes and restrictions to social and sanitary practices have presented significant issues in access to eye care during the COVID-19 pandemic. A reduction of more than 80% in pediatric eye care volume up to its total cessation has been observed in different departments. In this scenario, reduced or absent eyesight, due to delay in timely treatment of amblyopic conditions, could create major, long-lasting effects on all aspects of life, including daily personal activities, interacting with the community, school and work opportunities and the ability to access public services. Processes coming out of lockdown should be gradually easing restrictions giving priority to ophthalmology and eye care facilities so that amblyopia does not remain unattended and irreversible as in adults due to lack of timely treatments. If not reversible, this process could lead to a dramatic increase in disability and unsustainable social costs for many governments.