Objective  To examine health literacy level and its influencing factors among primary school students undergoing healthy campus program in Qingdao city of Shandong province and to provide references for implementing effective health literacy intervention in the students.

  Methods  We carried out a survey among 6 144 pupils recruited with stratified cluster random sampling in 32 primary schools in Qingdao city using two versions of Health Literature Questionnaire for 1 – 3 grade and 4 – 6 grade students in October 2016, 12 years after the implementation of health campus program.

  Results  Of all the pupils, 76.3% were assessed as being with basic health literacy and the proportions of the pupils with basic health knowledge and theory, healthy lifestyle and behavior, and fundamental skills were 67.4%, 84.3%, and 81.0%, respectively. The results of multivariate logistic regression demonstrated that the girl pupils (odds ratio OR = 1.311), low-grade pupils (OR = 1.240), living in urban area (OR = 1.636), being an only child (OR = 1.240), and with a father working as a business man/a self-employed entrepreneur/in service industry (OR = 1.452) were more likely to have a high health literacy; the pupils with a higher self-assessed education attainment and with higher parental education were also more likely to have a high health literature (both P < 0.05).

  Conclusion  The pupils undergoing healthy campus program in Qingdao city have a good health literacy and their health literacy is influenced by gender, grade of study, residing region, self-assessed education attainment, parental education, paternal occupation, and whether being an only child.