JMIR Publications

ABSTRACT

Background:

Medication literacy denotes the capacity to obtain, understand, evaluate, and utilize medication-related information for safe and effective medication decisions. While crucial, children remain highly vulnerable to medication risks due to physiological sensitivities and frequent off-label prescribing. Current research predominantly focuses on the elderly, leaving a critical gap in self-reported pediatric data. Furthermore, existing studies lack comprehensive frameworks assessing how individual, familial, and societal factors within China’s unique context influence children’s medication literacy.

Objective:

Medication literacy denotes the capacity to obtain, understand, evaluate, and utilize medication-related information for safe and effective medication decisions. Grounded in the Social-Ecological Model (SEM), this study aimed to investigate the prevalence of medication literacy and identify the factors associated with it among children in China.

Methods:

This study constituted a large-scale, multi-center, cross-sectional survey based on self-reported data, conducted across Mainland China from October, 2022 to May, 2023, under the title “Medication Literacy Investigation of Chinese Children”. Medication literacy, medication self-efficacy, loneliness, and perceived social support were assessed using the Medication Literacy Scale, Children’s Medication Self-Efficacy Scale (CMCES), Three-Item Loneliness Scale (T-ILS), and Chinese version of the Perceived Social Support Scale (PSSS), respectively. The survey data were analyzed employing multiple stepwise regression to examine factors associated with medication literacy. Standardized regression coefficients (β) and 95% confidence intervals (CIs) were calculated through this regression analysis.

Results:

A total of 4404 participants (mean[SD] 2067 female participants[46.93%], 2337 male participants[53.07%]) were analyzed in our study. The median score for children’s medication literacy in China was 48.36 points. The results of multiple regression analysis indicated that several factors were associated with medication literacy: older age (β = 0.025, 95%CI 0.664~1.043), male children (β = 0.050, 95%CI -1.614~-0.506), urban household registration location (β = 0.041, 95%CI 0.245~1.529), having a private room (β = 0.026, 95%CI 0.010~1.576), higher levels of perceived social support (β = 0.138, 95%CI 0.299~0.466), loneliness (β = -0.051, 95%CI -0.491~-0.153), and medication self-efficacy (β = -0.407, 95%CI -1.140~-1.000).

Conclusions:

Chinese children’s medication literacy is shaped by medication self-efficacy, family environment, and social support, as conceptualized within the SEM. These findings provide an empirical basis for designing targeted intervention strategies. Furthermore, the study highlights the potential influence of China’s distinct institutional and familial structures on children’s medication literacy, offering culturally relevant insights for enhancing health literacy in future generations. Clinical Trial: Registry: Medical Ethics Committee of Beijing Children’s Hospital, affiliated with Capital Medical University Trial registration number: ChiCTR2300072573 Data of registration: 2023-06-16 Clinical Trial Number: No. [2023]-E-015-R