Levels of health literacy among Australians with chronic conditions engaging with healthcare providers and navigating the health system

Health literacy plays an important role in improving person-centred care and population health outcomes. With the rate of chronic conditions increasing globally, it is important to understand the associations between levels of health literacy and the ability to navigate and engage with the healthcare system. A 39-item survey was designed and distributed to Australian adults aged ≥ 18. Participants were recruited between 29 November and 14 December 2018. In addition to researcher-devised and consumer-devised questions, items about self-reported health status, health conditions and PHI were drawn from the National Health Survey. Questions about financial stress were derived from the Household, Income and Labour Dynamics in Australia (HILDA) survey. Questions about care affordability were drawn from the Commonwealth Fund survey and questions about accessibility were sourced from the Menzies-Nous surveys. Questions about diagnosed chronic conditions were defined by the AIHW. Minor post-weighting adjustments were made by age, sex and state to ensure the data accurately reflected population distribution according to the Australian Bureau of Statistics in June 2018. Data were analysed using descriptive and inferential statistics (IBM SPSS Statistics V24). Weighting was undertaken through a survey raking technique using the anesrake package in R.The full survey questions are included in file 2, and with codes that correspond to the datasheet.健康素养（health literacy）在提升以患者为中心的照护与人群健康结局方面发挥着重要作用。随着全球慢性病患病率持续攀升，明晰健康素养水平与医疗系统导航及参与能力之间的关联具有重要意义。本研究设计了一份包含39个题项的调查问卷，并向18岁及以上的澳大利亚成年人群发放。调研对象招募时段为2018年11月29日至12月14日。除研究者自行设计与受访者拟定的题项外，有关自我报告健康状况、慢性病情况及个人健康信息（PHI）的题项均取自澳大利亚国民健康调查（National Health Survey）。有关经济压力的题项源自澳大利亚家庭、收入与劳动力动态调查（Household, Income and Labour Dynamics in Australia, HILDA）。照护可负担性相关题项取自联邦基金（Commonwealth Fund）调研，医疗可及性相关题项则来源于门齐斯-努斯（Menzies-Nous）系列调查。经确诊的慢性病相关题项定义标准由澳大利亚健康与福利研究所（AIHW）制定。研究团队依据2018年6月澳大利亚统计局（Australian Bureau of Statistics）发布的人口分布数据，对样本按年龄、性别与州属进行了小幅事后加权调整，以确保数据准确反映人口分布特征。本研究采用描述性与推断性统计方法（IBM SPSS Statistics V24）对数据进行分析，并通过R语言的anesrake工具包运用调查加权raking技术完成加权处理。完整调查问卷题项收录于文件2中，且附带与数据集表格对应的编码信息。