Objective: To explore the association between middle school students health literacy and bully victimization and associated sex difference, and to provide guidance for bully prevention in adolescents. Methods: During November 2017 to January 2018, 18 900 junior and senior high school students were enrolled from Hefei of Anhui Province, Shenyang of Liaoning Province, Yangjiang of Guangdong Province and Chongqing by multistage cluster sampling. A self rated questionnaires were used to collect demographic information, health literacy, and bully victimization. Group differences by different characteristics and the association between health literacy and bully victimization were analyzed. Results: The detection rates of campus and cyber bullying victimization were 15.8% (2 992/18 900) and 9.1% (1 723/18 900). Boys, junior high school students, students with poor family financial status and few close friends had a detection rate of 28.0%, 18.8%, 23.3%, and 33.6% of school bullying, which are higher than those of the control group ( χ 2=225.64, 148.07, 141.13, 143.49, P <0.01); boys, students with poor household income and few close friends, the detection rates of cyber bullying were 10.9%, 14.4%, and 20.1%, respectively, are higher than the control group ( χ 2=62.96, 112.82, 88.49, P <0.01). Multivariate Logistic regression analysis indicated that students with low overall and dimensions scores of health literacy were more likely to suffer from campus and cyber bullying, except for the dimension of physical activity. In addition, at all levels of health literacy, males are more likely to be bullied than females ( P <0.05). Conclusion Health literacy of middle school students is related to bully victimization, which is sex specific. Intervention programs of bullying should focus on health literacy enhancement.

Objective: To explore the association between health literacy and drinking behaviors among middle school students in six provinces of China, and to provide scientific basis for the prevention and intervention of drinking behaviors. Methods: From November 2015 to January 2016, 22 628 students were enrolled from Ulanqab, Shenyang, Xinxiang, Bengbu, Chongqing and Yangjiang by multistage stratified cluster sampling method. And a questionnaire survey was conducted among them to collect demographic information, health literacy and drinking behaviors. Rates on drinking behaviors were compared in students with specific characteristics. Multiple Logistic regression analyses were conducted to examine the association between health literacy and drinking behaviors. Results: The proportion of ever drinking, current drinking, binge drinking, drunkenness was 60.0%(13 580), 16.8%(3 799), 5.9%(1 344) and 9.9%(2 250), respectively. After adjusting for gender, grade, family address, siblings, accommodation type, parental educational level, and self reported family income, compared to the high level health literacy, the low level health literacy was significantly associated with ever drinking (OR=1.76, 95%CI=1.62-1.91), current drinking(OR=1.37, 95%CI=1.23-1.52), binge drinking (OR=1.39, 95%CI=1.18-1.63), and drunkenness(OR=1.68, 95%CI=1.47-1.92), respectively(P<0.01). Conclusion Health literacy of middle school students was related to drinking behaviors. The occurrence of health risk behaviors such as drinking can be prevented and reduced by improving students health literacy level.