Design of a study protocol for a cross-sectional investigation into health literacy levels among elderly individuals in China.

INTRODUCTION: This nationwide, community-based, multicentre epidemiological survey seeks to evaluate the status, distribution and determinants of health literacy among Chinese adults aged 60 years and older. It addresses the limited representativeness of previous local studies and scarcity of data on advanced-age populations, thereby providing an evidence base for policies to improve health literacy in this demographic. METHODS AND ANALYSIS: Led by the National Centre for Chronic and Non-communicable Disease Control and Prevention (NCNCD), this survey uses a multi-stage complex sampling design across 124 districts in all 31 provinces of China. Launched in 2022, the survey is conducted annually, recruiting 24 800 participants each year. Data collection includes demographic information, health literacy assessment (knowledge, attitudes and skills), health information channels, health behaviours and health status. Statistical analyses will assess health literacy levels, influencing factors and urban-rural/gender disparities. ETHICS AND DISSEMINATION: Ethical approval was obtained from the NCNCD Ethical Review Committee (Approval No. 202110;12 July 2021). Ongoing reviews are conducted on an annual basis, and three ethical reviews have been completed. Findings will be disseminated through peer-reviewed publications and conference presentations, ensuring participant confidentiality.