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Article(id=1325530161172725971, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325530078536553117, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025282, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1751558400000, receivedDateStr=2025-07-04, revisedDate=1756396800000, revisedDateStr=2025-08-29, acceptedDate=null, acceptedDateStr=null, onlineDate=1793960617582, onlineDateStr=2026-11-06, pubDate=1758729600000, pubDateStr=2025-09-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793960617582, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793960617582, creator=13701087609, updateTime=1793960617582, updator=13701087609, issue=Issue{id=1325530078536553117, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='9', pageStart='1217', pageEnd='1368', issueExtLink='null', onlineDate='null', pubDate='1758729600000', pubDateStr='2025-09-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793960597879, creator='13701087609', updateTime=1793960597879, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1355, endPage=1360, ext={EN=ArticleExt(id=1325530162888196308, articleId=1325530161172725971, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Research progress on adolescent health literacy assessment tools, columnId=1325500927146341345, journalTitle=Chinese Journal of School Health, columnName=Review, runingTitle=null, highlight=null, articleAbstract=

Adolescent health literacy constitutes a fundamental, economical and effective strategy for addressing their health issues and fostering healthy behaviors, while assessing health literacy plays a pivotal role in evaluating adolescents' health literacy. The study systematically reviews existing adolescent health literacy assessment tools at both domestically and internationally, and analyzes them through three dimensions: structural components, applicability and scientific validity. It further examines emerging trends in the development of such tools, aiming to offer theoretical underpinnings and practical recommendations for their refinement, thereby more effectively addressing the evolving health needs of adolescents.

, authors=Qingyuan ZHOU, Zhihua YIN*, Jiajun JIANG, authorsList=Qingyuan ZHOU, Zhihua YIN, Jiajun JIANG, authorCompany=null, correspAuthors=Zhihua YIN, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325530163630588117, articleId=1325530161172725971, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=青少年健康素养测评工具研究进展, columnId=1325500927309919203, journalTitle=中国学校卫生, columnName=综述, runingTitle=null, highlight=null, articleAbstract=

青少年健康素养是促进其健康问题应对、健康行为养成的最根本、最经济且最有效的策略，而健康素养测评有助于了解青少年健康素养水平。研究系统梳理了国内外现有测评工具，并从构成性、适用性与科学性三个方面展开分析，进一步探讨其未来发展趋势，旨在为完善青少年健康素养测评工具功能提供理论依据和实践指导，以更好地满足青少年健康需求。

, authors=周清源, 尹志华*, 降佳俊, authorsList=周清源, 尹志华, 降佳俊, authorCompany=null, correspAuthors=尹志华, authorNote=

周清源(2002-)，女，江苏高邮人，在读硕士，主要研究方向为儿童青少年体质健康促进

, correspAuthorsNote=
尹志华，E-mail：
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周清源(2002-)，女，江苏高邮人，在读硕士，主要研究方向为儿童青少年体质健康促进

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Development and application of the Adolescent Mental Health Literacy Assessment Questionnaire among medical under-graduates[J]. Chin J Sch Health, 2021, 42(7): 1038-1041. 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Development of Infectious Disease-Prevention Health Literacy Scale for Chinese Middle School Students[J]. Chin J Sch Health, 2022, 43(4): 526-529, 535. (in Chinese), articleTitle=null, refAbstract=null), Reference(id=1325530173646586161, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=45, rfOrder=62, authorNames=null, journalName=null, refType=null, unstructuredReference=昝子晴, 刘丽珠, 李梦宇, 等. 基于CTT和Rasch模型分析的初中生运动健康素养评价工具研究[J/OL]. 中国全科医学, 2025: 1-9. (2025-03-18). https://kns.cnki.net/kcms/detail/13.1222.R.20250318.0851.002.html., articleTitle=null, refAbstract=null), Reference(id=1325530173709500722, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=45, rfOrder=63, authorNames=null, journalName=null, refType=null, unstructuredReference=ZAN Z Q, LIU L Z, LI M Y, et al. Development, reliability and validity of the sports health literacy assessment instrument for middle school students based on CTT and Rasch model[J/OL]. Chin Gen Pract, 2025: 1-9. (2025-03-18). https://kns.cnki.net/kcms/detail/13.1222.R.20250318.0851.002.html. (in Chinese), articleTitle=null, refAbstract=null), Reference(id=1325530173776609587, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=46, rfOrder=64, authorNames=null, journalName=null, refType=null, unstructuredReference=贾碧波, 汪培, 朱桂因, 等. 儿童青少年健康素养研究现状与进展[J]. 中国学校卫生, 2023, 44(4): 622-626., articleTitle=null, refAbstract=null), Reference(id=1325530173843718452, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=46, rfOrder=65, authorNames=null, journalName=null, refType=null, unstructuredReference=JIA B B, WANG P, ZHU G Y, et al. Research status and progress of health literacy for children and adolescents[J]. 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A global literature review on digital health literacy[J/OL]. Libr Dev, 2024: 1-14[2025-09-22]. https://link.cnki.net/urlid/23.1331.g2.20241202.1111.002. (in Chinese), articleTitle=null, refAbstract=null), Reference(id=1325530174074405175, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=48, rfOrder=68, authorNames=null, journalName=null, refType=null, unstructuredReference=白媛媛, 王焕倩, 昝子晴, 等. 儿童青少年健康素养评估工具的研究进展[J]. 中国健康教育, 2021, 37(9): 838-841., articleTitle=null, refAbstract=null), Reference(id=1325530174158291256, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=48, rfOrder=69, authorNames=null, journalName=null, refType=null, unstructuredReference=BAI Y Y, WANG H Q, ZAN Z Q, et al. Review of health literacy and its evaluation methods for children and adolescents[J]. Chin J Health Educ, 2021, 37(9): 838-841. (in Chinese), articleTitle=null, refAbstract=null), Reference(id=1325530174229594425, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=49, rfOrder=70, authorNames=null, journalName=null, refType=null, unstructuredReference=郭嘉悦, 昝子晴, 刘丽珠, 等. 儿童青少年健康素养内涵及测评工具研究进展[J]. 中国健康教育, 2024, 40(10): 865-869, 883., articleTitle=null, refAbstract=null), Reference(id=1325530174296703290, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=49, rfOrder=71, authorNames=null, journalName=null, refType=null, unstructuredReference=GUO J Y, ZAN Z Q, LIU L Z, et al. Progress on the connotation of children and adolescents' health literacy and assessment tools[J]. Chin J Health Educ, 2024, 40(10): 865-869, 883. (in Chinese), articleTitle=null, refAbstract=null)], funds=[Fund(id=1325530165471887602, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, awardId=null, language=CN, fundingSource=国家社会科学基金后期资助重点项目(23FTYA004)；青少年健康评价与运动干预教育部重点实验室开放基金项目(40500-23204-542500/006/012)；教育部课程教材研究所重点项目(JCSZDXM2022002), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325530163852886230, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, xref=null, ext=[AuthorCompanyExt(id=1325530163861274839, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, companyId=1325530163852886230, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=College of Physical Education and Health, East China Normal University, Shanghai 200241, China), AuthorCompanyExt(id=1325530163869663448, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, companyId=1325530163852886230, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=华东师范大学体育与健康学院，上海 200241)])], figs=[ArticleFig(id=1325530165262172400, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, language=EN, label=Tab.1, caption=

List of characteristics of adolescent health literacy assessment tools

, figureFileSmall=null, figureFileBig=null, tableContent=
序号工具名称构成性适用性科学性
内容及条目数题型对象场景时长类型信度系数局限
1REALM-Teen[17]按难度排列的66个词汇单词识别10~19岁临床2.5 min客观T=0.94仅测词汇识别；文化适应性不足
2REALM-TeenS[19]按难度排列的10个词汇单词识别10~19岁临床20 s客观T=0.82词汇代表性、文化适应性不足
3NVS-PTeen[20]冰淇淋标签6个阅读理解、数值计算八至十二年级/12~17岁学校6 min客观K=0.61样本单一；缺乏青少年文化适配
4HAS-A[21]3个分量表：功能性、互动性、批判性，4个领域：获取、交流、理解、处理，共62题量表题12~19岁临床/学校—主观T=0.78
D=0.73~0.77		样本代表性不足；维度覆盖有限
5HLSAC[23]5个维度：理论知识、实践知识、批判性思维、自我意识、公民意识，10题量表题七至九年级/
13~15岁		学校—主观T=0.93年龄适用有限；题项设计需优化
6AAHL[22]3个维度：功能性、互动性、批判性，23题图表解读、阅读理解、数值计算、多选题等12~18岁学校—客观K=0.63/0.74/0.74样本代表性不足；公平性待验证
7HELMA[24]8个维度：信息获取、阅读、理解、评估、使用、交流、自我效能、计算能力，44题量表题15~18岁学校15 min主观T=0.93不同年龄和环境待验证
8MOHLAA-Q[25]4个维度：健康信息处理、沟通与互动技能、健康态度、健康知识，29题量表题、判断题14~17岁学校/
公共卫生		—主观D=0.54~0.77结构效度与一致性不足；样本代表性不足
9AHLQ[26]6个维度：健康知识，优质健康信息的来源，促进因素与障碍，他人影响，自我效能、自我管理与复原力，公民意识与沟通，41题情境题、量表题12~18岁学校—主观—样本偏倚；样本量有限
10中国青少年互动性健康素养评定问卷[34]6个维度：健康意识、体力活动、人际关系、压力管理、精神成长、营养，31题量表题初中生+高中生学校—主观T=0.94
D≥0.70		样本区域有限，代表性不足
11青少年健康素养与健康状况调查问卷[35]3个维度：基本知识和理念、健康生活方式与行为、基本技能，71题选择题小学生+初中生/
(13.2±1.2)岁		学校20 min主观T=0.70
D=0.68~0.72		作答形式单一；对象覆盖有限
12中学生健康素养量表[41]5个维度：健康理念、基本健康知识、健康生活方式与行为、健康认知技能、操作技能，31题判断题、单选题、多选题、情境模拟题六年级+初中生+
高中生/11~19岁		学校—主/
客观		T=0.74
D=0.54~0.68		自填影响客观性；一致性偏低
13初中生健康素养量表[36]3个维度：功能性、互动性、评判性，9个因子：科学健康观、营养饮食、疾病预防、青春期发育、心理健康、意外伤害与急救、问题解决能力、健康决定能力、健康评判能力，共50题量表题初中生/(13.95±
1.54)岁		学校—主观T=0.95 D=0.86~0.95样本局限于单校
14中小学生健康素养评价工具[40]小学、初中、高中各4个一级维度：健康知识、健康理念、健康技能、健康行为，分别有71，78，70个条目—小学生+初中生+高中生学校—主/
客观		T≥0.70题目难度与区分度低；适用范围待完善
15中学生健康素养问卷[42]3个分量表：珍爱生命、健全人格和自我管理，10个子维度：生命意义、网络健康行为、健康生活方式、青春期健康知识、自尊自信、自立自强、感恩、自我激励与时间管理、未来生涯规划、社会自我认识，共37题量表题初中生+高中生/
(14.11±1.56)岁		学校—主观T=0.92
D=0.70/0.86/0.87		样本量不足；缺乏线上监测系统
16中国初中生综合健康素养测评问卷[37]4个维度：健康知识、健康技能、健康动机、健康相关行为，57题判断题、选择题、量表题初中生学校—主/
客观		T=0.82
D=0.77/0.68		需结合政策动态修订；验证不足
17中国高中生健康素养评价量表[38]横向维度：健康行为与生活方式、生长发育与青春期保健、心理健康、传染病预防与突发公共卫生事件应对、安全应急与避险，纵向维度：知识、态度、技能、行为，共39题单选题、多选题、量表题高中生学校20 min主/
客观		T=0.91缺全国代表性；题目设计与难度需优化
), ArticleFig(id=1325530165354447089, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530161172725971, language=CN, label=表1, caption=

青少年健康素养测评工具特征列表

, figureFileSmall=null, figureFileBig=null, tableContent=
序号工具名称构成性适用性科学性
内容及条目数题型对象场景时长类型信度系数局限
1REALM-Teen[17]按难度排列的66个词汇单词识别10~19岁临床2.5 min客观T=0.94仅测词汇识别；文化适应性不足
2REALM-TeenS[19]按难度排列的10个词汇单词识别10~19岁临床20 s客观T=0.82词汇代表性、文化适应性不足
3NVS-PTeen[20]冰淇淋标签6个阅读理解、数值计算八至十二年级/12~17岁学校6 min客观K=0.61样本单一；缺乏青少年文化适配
4HAS-A[21]3个分量表：功能性、互动性、批判性，4个领域：获取、交流、理解、处理，共62题量表题12~19岁临床/学校—主观T=0.78
D=0.73~0.77		样本代表性不足；维度覆盖有限
5HLSAC[23]5个维度：理论知识、实践知识、批判性思维、自我意识、公民意识，10题量表题七至九年级/
13~15岁		学校—主观T=0.93年龄适用有限；题项设计需优化
6AAHL[22]3个维度：功能性、互动性、批判性，23题图表解读、阅读理解、数值计算、多选题等12~18岁学校—客观K=0.63/0.74/0.74样本代表性不足；公平性待验证
7HELMA[24]8个维度：信息获取、阅读、理解、评估、使用、交流、自我效能、计算能力，44题量表题15~18岁学校15 min主观T=0.93不同年龄和环境待验证
8MOHLAA-Q[25]4个维度：健康信息处理、沟通与互动技能、健康态度、健康知识，29题量表题、判断题14~17岁学校/
公共卫生		—主观D=0.54~0.77结构效度与一致性不足；样本代表性不足
9AHLQ[26]6个维度：健康知识，优质健康信息的来源，促进因素与障碍，他人影响，自我效能、自我管理与复原力，公民意识与沟通，41题情境题、量表题12~18岁学校—主观—样本偏倚；样本量有限
10中国青少年互动性健康素养评定问卷[34]6个维度：健康意识、体力活动、人际关系、压力管理、精神成长、营养，31题量表题初中生+高中生学校—主观T=0.94
D≥0.70		样本区域有限，代表性不足
11青少年健康素养与健康状况调查问卷[35]3个维度：基本知识和理念、健康生活方式与行为、基本技能，71题选择题小学生+初中生/
(13.2±1.2)岁		学校20 min主观T=0.70
D=0.68~0.72		作答形式单一；对象覆盖有限
12中学生健康素养量表[41]5个维度：健康理念、基本健康知识、健康生活方式与行为、健康认知技能、操作技能，31题判断题、单选题、多选题、情境模拟题六年级+初中生+
高中生/11~19岁		学校—主/
客观		T=0.74
D=0.54~0.68		自填影响客观性；一致性偏低
13初中生健康素养量表[36]3个维度：功能性、互动性、评判性，9个因子：科学健康观、营养饮食、疾病预防、青春期发育、心理健康、意外伤害与急救、问题解决能力、健康决定能力、健康评判能力，共50题量表题初中生/(13.95±
1.54)岁		学校—主观T=0.95 D=0.86~0.95样本局限于单校
14中小学生健康素养评价工具[40]小学、初中、高中各4个一级维度：健康知识、健康理念、健康技能、健康行为，分别有71，78，70个条目—小学生+初中生+高中生学校—主/
客观		T≥0.70题目难度与区分度低；适用范围待完善
15中学生健康素养问卷[42]3个分量表：珍爱生命、健全人格和自我管理，10个子维度：生命意义、网络健康行为、健康生活方式、青春期健康知识、自尊自信、自立自强、感恩、自我激励与时间管理、未来生涯规划、社会自我认识，共37题量表题初中生+高中生/
(14.11±1.56)岁		学校—主观T=0.92
D=0.70/0.86/0.87		样本量不足；缺乏线上监测系统
16中国初中生综合健康素养测评问卷[37]4个维度：健康知识、健康技能、健康动机、健康相关行为，57题判断题、选择题、量表题初中生学校—主/
客观		T=0.82
D=0.77/0.68		需结合政策动态修订；验证不足
17中国高中生健康素养评价量表[38]横向维度：健康行为与生活方式、生长发育与青春期保健、心理健康、传染病预防与突发公共卫生事件应对、安全应急与避险，纵向维度：知识、态度、技能、行为，共39题单选题、多选题、量表题高中生学校20 min主/
客观		T=0.91缺全国代表性；题目设计与难度需优化
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青少年健康素养测评工具研究进展
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周清源 , 尹志华 * , 降佳俊
中国学校卫生 | 综述 2025,46(9): 1355-1360
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中国学校卫生 |综述 2025 , 46 (9) : 1355 -1360
青少年健康素养测评工具研究进展
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周清源, 尹志华* , 降佳俊
作者信息
  • 华东师范大学体育与健康学院，上海 200241
通讯作者:
尹志华，E-mail：
作者简介:

周清源(2002-)，女，江苏高邮人，在读硕士，主要研究方向为儿童青少年体质健康促进

Research progress on adolescent health literacy assessment tools
Qingyuan ZHOU, Zhihua YIN* , Jiajun JIANG
Affiliations
  • College of Physical Education and Health, East China Normal University, Shanghai 200241, China
出版时间: 2025-09-25 doi: 10.16835/j.cnki.1000-9817.2025282
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摘要
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青少年健康素养是促进其健康问题应对、健康行为养成的最根本、最经济且最有效的策略，而健康素养测评有助于了解青少年健康素养水平。研究系统梳理了国内外现有测评工具，并从构成性、适用性与科学性三个方面展开分析，进一步探讨其未来发展趋势，旨在为完善青少年健康素养测评工具功能提供理论依据和实践指导，以更好地满足青少年健康需求。

健康教育  /  工具使用行为  /  青少年  /  健康促进

Adolescent health literacy constitutes a fundamental, economical and effective strategy for addressing their health issues and fostering healthy behaviors, while assessing health literacy plays a pivotal role in evaluating adolescents' health literacy. The study systematically reviews existing adolescent health literacy assessment tools at both domestically and internationally, and analyzes them through three dimensions: structural components, applicability and scientific validity. It further examines emerging trends in the development of such tools, aiming to offer theoretical underpinnings and practical recommendations for their refinement, thereby more effectively addressing the evolving health needs of adolescents.

Health education  /  Tool use behavior  /  Adolescent  /  Health promotion
周清源, 尹志华, 降佳俊. 青少年健康素养测评工具研究进展. 中国学校卫生, 2025 , 46 (9) : 1355 -1360 . DOI: 10.16835/j.cnki.1000-9817.2025282
Qingyuan ZHOU, Zhihua YIN, Jiajun JIANG. Research progress on adolescent health literacy assessment tools[J]. Chinese Journal of School Health, 2025 , 46 (9) : 1355 -1360 . DOI: 10.16835/j.cnki.1000-9817.2025282
正文
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青少年营养失衡、体质下降及视力不良等健康问题持续加剧，已成为全球公共卫生领域面临的重大挑战[1-2]。健康素养作为个体获取、理解并运用基本健康信息和服务，以做出正确决策从而维护和促进健康的能力[3]，其提升被认为是应对上述问题最根本、最经济且有效的策略。鉴于其在青少年健康发展中的重要作用，我国已将提升学生健康素养列为新时代学校卫生与健康教育的重点任务[4]。因此，亟须系统科学的测评工具，以客观准确地评估青少年健康素养水平。然而，相关研究尚处于起步阶段，目前多集中于理论内涵[5-6]、影响因素[7-9]、现状水平[10-11]及干预策略[12-13]等方面，且测评指标与测评工具主要针对成人群体，未能充分体现青少年的特点与需求。基于此，本研究旨在系统梳理国内外青少年健康素养测评工具的开发现状，分析其构成性、适用性与科学性特征，预测发展趋势，以期为我国测评工具的优化及测评水平的提升提供理论依据与实践指导。
1　青少年健康素养测评工具的系统梳理
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1.1　国外青少年健康素养测评工具
国外青少年健康素养测评工具大致可分为两类：一类是在经典成人测评工具基础上延伸与改编的版本；另一类是根据各国文化背景和健康教育需求自主开发的工具。前者代表性工具包括被广泛认可为“金标准”的成人医学语言阅读能力测评量表(Rapid Estimate of Adult Literacy in Medicine, REALM)[14]、成人功能性健康素养测评量表(Test of Functional Health Literacy in Adults, TOFHLA)[15]和最新关键指标测评量表(Newest Vital Sign, NVS)[16]，并由此发展出多个适用于青少年的版本。例如，青少年医学语言阅读能力测评量表(Rapid Estimate of Adolescent Literacy in Medicine, REALM-Teen)[17]包含66个按难度排序的相关词汇[18]，另有简化版REALM-Teen(REALM-TeenS)仅保留10个核心词汇[19]；TOFHLA虽未推出专门的青少年版本，但其阅读理解部分在该群体中验证效度良好[15]；NVS因操作简便常用于青少年快速筛查[16]，并衍生出葡萄牙青少年版(Newest Vital Sign for the Portuguese Adolescents' Population, NVS-PT-een)[20]。此外，近年来亦有直接面向青少年开发的工具。如Manganello等[21]设计的青少年健康素养测评量表(Health Literacy Assessment Scale for Adolescents, HAS-A)与Fleary等[22]开发的青少年健康素养测评工具(Assessments of Adolescent Health Literacy, AAHL)，均涵盖功能性、互动性和批判性3个层次维度；Paakkari等[23]构建的学龄儿童健康素养测评工具(Health Literacy for School-aged Children, HLSAC)从获取、理解、评估与应用健康信息等方面测评青少年主观健康素养水平。
鉴于通用工具难以准确反映各国青少年的实际状况，有些国家开发了符合国情的测评工具。例如，伊朗的青少年健康素养测量工具(Health Literacy Measure for Adolescents, HELMA)涵盖信息获取、交流等8个维度[24]；德语环境下开发的首个青少年健康素养测评问卷(Measurement of Health Literacy among Adolescents Questionnaire, MOHLAA-Q)包括健康态度等4个维度[25]；爱尔兰的青少年健康素养调查问卷(Adolescent Health Literacy Questionnaire, AHLQ)则强调健康素养受优质健康信息可获取性、自我效能等6个要素影响[26]。
1.2　国内青少年健康素养测评工具
主要可归为3类。第1类为引入国际通用量表并调适修订的工具，在继承原量表理论框架与维度科学性的同时，结合我国社会文化语境提高其适应性。尽管此类研究多集中于成人群体，面向青少年的探索亦有开展：2012年，Chang等[27]基于简化版TOFHLA修订形成中文青少年版(Chinese version of Short-form Test of Functional Health Literacy in Adolescents, c-sTOFHLAd)；2022年，王焕倩等[28]汉化NVS并调整营养标签以符合中国食品包装规范；2023年，Chou等[29]完成HAS-A的翻译与本土化修订，主要改进在于语言和文化的适配。
第2类为立足本土政策或现实需求编制的工具。一方面，得益于政策层面对健康素养监测的推动。2008年，《中小学健康教育指导纲要》明确提出五大领域健康素养目标[30]；自2012年起，原卫生部依据《中国公民健康素养——基本知识与技能》建立年度居民监测机制，涵盖总体健康素养及三个领域、六类健康问题[31]；2023年，《身体素养评价指标体系第2部分：青少年》发布，涉及健康促进与维护[32]。然而，落实中仍存在配套测评工具不完备、青少年群体监测不充分、维度覆盖不全面等共性问题[33]。另一方面，国内学者基于青少年健康素养测评的潜在健康效益与长远社会意义，积极推进分学段测评工具的研发。针对青少年总体人群，张诗晨等[34]和魏保健[35]分别编制了《中国青少年互动性健康素养评定问卷》和《青少年健康素养与健康状况调查问卷》；在初中阶段，王翎懿等[36-37]构建了相应量表；在高中阶段，郭世豪等[38]依据《生命安全与健康教育进中小学课程教材指南》[39]开发了专门评价量表。此外，余小鸣等[40]建立了中小学测评指标体系与题库，康玫等[41-42]则研制了适用于中学生的测评量表。
第3类为聚焦特定健康主题或行为场景的工具。随着青少年健康问题的类型化与复杂化，相关工具正不断延展与细化。如针对青少年易出现的心理困扰，李丹琳等[43]编制了《青少年心理健康素养评定量表》；面对学生免疫系统发育不成熟及校园集体生活易导致传染病传播的风险，李远骋等[44]编制了《中国中学生传染病预防健康素养评价量表》；围绕青少年身体活动不足和体质不佳等问题，昝子晴等[45]编制了《初中生运动健康素养问卷》。
2　青少年健康素养测评工具的特点分析
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选取国内外结构与内容相对完善、具有代表性的测评工具进行归纳分析(表1)，由于多数汉化工具直接沿用原有结构，政策性文件缺乏可操作的具体工具，而特定主题工具适用范围较为有限，故未纳入。
2.1　测评工具的构成性分析
从构成性视角来看，青少年健康素养测评工具的发展呈现出3个层面的递进演化。首先，在构成维度上，早期工具如REALM-Teen、NVS-PTeen主要聚焦功能性健康素养[17, 20]，结构相对单一、仅涉及健康词汇识别或基础信息理解，难以全面反映青少年在真实情境中处理健康信息的综合能力。随着相关理论深化，尤其是Nutbeam三维模型的推广，测评内容拓展至功能性、互动性与批判性3个方面，并进一步融入“知识、态度、技能、行为”或“获取、交流、理解、处理”等更具层级性的子维度[21-22, 38]。其次，在构成内容上，工具设计愈发关注与青少年身心发展特点的适配性。考虑到其处于身心快速发育、自我意识逐渐增强的关键窗口期，测评工具引入了营养饮食、青春期发育、生涯规划等主题[36, 38, 42]，体现内容朝更加具体化、发展性方向延展。再次，在构成形式上，多数工具将题目数量控制在30~50项之间[41-42]，兼顾测评深度与操作可行性；题型设置也突破以往以选择题、判断题为主的单一形式，发展出包括量表题、情境模拟题、数值推算等多样形式，如AAHL、AHLQ等工具通过任务化或情境化题型，有效提升测评的真实性与辨识力[22, 26]。总体而言，测评工具正形成横向覆盖多类主题、纵向贯通不同能力的立体化体系。
2.2　测评工具的适用性分析
在分类标准上，国外研究通常依据生理年龄划分研究对象，如12~18或14~17岁等具体年龄段[22, 25]；而国内多以学段为界，按照小学、初中、高中等教育阶段进行划分[34-38]。这一差异在一定程度上影响了测评工具的可比性与通用性，因此应明确以年龄或学段为分类依据，并在逻辑上保持一致，构建既体现发展阶段差异又具时间连续性的测评内容，为青少年健康素养水平的横向比较与纵向追踪提供保障。
在实施场景上，国外更强调其在临床与医疗环境中的适配性；而国内工具多服务于学校健康教育与公共卫生宣传，侧重于教育系统内的推广应用。尽管学校场景具有较强的组织与管理优势，但青少年健康素养的形成亦受家庭氛围、社区资源以及医疗服务接触等多种因素影响。因此，应设计可应用于多元情境的测评工具，以实现跨场域的有效迁移与协同干预。
在测评时长上，部分临床工具如REALM-TeenS，将测评时间控制在30 s以内，以满足快速筛查需求[19]；而常规工具时长一般集中在15~20 min。鉴于青少年注意力持续时间有限且易受外界干扰，应综合考量应用场景、任务复杂度及青少年认知负荷等，科学设定测评时长，以提升工具在实际应用中的接受度。
2.3　测评工具的科学性分析
近年来，测评工具经历了从单一客观或主观测评向主客观结合的演进。早期工具多采用标准化任务或事实性题项，强调对健康知识掌握、信息理解及操作能力的检验，但在态度、信念等心理和行为层面的评估存在局限。相比之下，主观测评更易反映个体的主观体验与行为倾向，呈现健康素养的情境性与交互性特征，但也易受社会期许与认知偏差干扰。因此，融合主客观测评方法并优化题项设计，有助于提升测评工具的全面性与科学性。在测评质量方面，信度作为核心指标，常以Cronbach α或KR-20系数衡量内部一致性[19-25]。尽管多数工具在总量表信度上表现良好(>0.70)，但维度间信度差异仍较突出；尤其在维度较多或涉及主观评价的量表中，部分指标偏低，提示题项表述或测量指向可能存在模糊问题。进一步来看，当前青少年健康素养测评工具在科学性方面仍存在多重短板：(1)样本代表性不足。缺乏多区域、多文化背景支持，影响适用广度。(2)内容覆盖有限。部分工具仍停留于词汇识别或认知判断层面，难以体现健康素养的多维构成。(3)题项设计存在难度分布不均、区分度低和文化适配性差等问题，影响测评效度与公平性。(4)技术手段滞后，仍以纸笔或自填问卷为主，缺乏动态数据与交互反馈能力。
3　青少年健康素养测评工具的发展趋势
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3.1　拓展维度内容，完善健康素养测评结构
目前，青少年健康素养测评工具正由单一维度向多维融合与系统整合转型，体现出对健康素养内涵理解的深化及工具现实关照能力的增强。未来，应在内容深度与广度上继续拓展。一方面，测评不仅延续对功能性健康素养的关注，也更加重视互动性、批判性健康素养等高阶能力；同时纳入心理、社会与行为等相关因素，以识别影响青少年健康素养的关键变量。另一方面，测评内容应更有针对性地匹配青少年不同的发展阶段及其所处的社会情境[46]。例如，在青春期阶段，测评侧重于性健康教育、认知成熟度等内容；而在升学过渡期应突出生涯规划意识、自我管理能力等。此外，伴随数字技术的快速发展，数字健康素养等新兴议题亦应成为未来测评工具的重要拓展方向[47]。
3.2　强化动态适应，提升多情境下的通用性
随着青少年健康素养测评需求的多元化发展，传统依赖单一应用场景的测评模式已难以有效响应现实挑战。未来，测评工具应朝向更具动态适应性的方向演进，广泛适用于学校教育、家庭指导、社区干预及医疗服务等多元场域[48]。针对不同文化背景、教育资源与发展水平的青少年群体，测评工具在语言表述、题型设计上将更加强调地域性与差异性。同时，工具结构亦将趋于模块化与层级化，以适应青少年成长阶段与发展任务的动态变化[49]，进而实现对同一对象的长期跟踪和持续评估。此外，测评形式将由静态、量化、集中化，转向动态、融合与情境化，以更好契合复杂多变的应用需求。
3.3　推进技术融合，推动个性化智能化测评
信息技术的迅猛发展为健康素养测评工具的智能化升级提供了契机。例如，通过智能终端与网络平台，题目可自适应推送，答题过程可实时记录，结果能够可视化呈现，有效提升测评效率及用户体验；借助数据挖掘与机器学习技术，工具将精准诊断个体短板，生成个性化反馈报告与健康教育建议；结合虚拟仿真与情境模拟技术，测评过程将更贴近真实生活情境，有助于增强测评的生态效度。最终实现从传统纸笔测评向数字化、个性化与智能化测评的跃升[33]。数据安全与伦理规范建设也将同步推进，为其发展提供制度保障与支撑。
4　小结
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健康素养测评不仅是识别青少年健康风险的重要手段，也是促进健康行为养成的有效抓手，对其社会适应具有长远意义。国外研究起步较早，近年来国内相关探索也逐步展开，构成日益丰富，适用性和科学性不断增强。未来，测评工具将在结构维度、情境适应与技术融合等方面持续推进，以提升其实效性。
基金
收起
  • 国家社会科学基金后期资助重点项目(23FTYA004)；青少年健康评价与运动干预教育部重点实验室开放基金项目(40500-23204-542500/006/012)；教育部课程教材研究所重点项目(JCSZDXM2022002)
文献
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参考文献 引证文献
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2025年第46卷第9期
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doi: 10.16835/j.cnki.1000-9817.2025282
  • 接收时间：2025-07-04
  • 首发时间：2026-11-06
  • 出版时间：2025-09-25
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  • 收稿日期：2025-07-04
  • 修回日期：2025-08-29
基金
国家社会科学基金后期资助重点项目(23FTYA004)；青少年健康评价与运动干预教育部重点实验室开放基金项目(40500-23204-542500/006/012)；教育部课程教材研究所重点项目(JCSZDXM2022002)
作者信息
    华东师范大学体育与健康学院，上海 200241

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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