BackgroundChildren and young people constitute a core target group for health literacy research and practice: during childhood and youth, fundamental cognitive, physical and emotional development processes take place and health-related behaviours and skills develop. However, there is limited knowledge and academic consensus regarding the abilities and knowledge a child or young person should possess for making sound health decisions. The research presented in this review addresses this gap by providing an overview and synthesis of current understandings of health literacy in childhood and youth. Furthermore, the authors aim to understand to what extent available models capture the unique needs and characteristics of children and young people.MethodSix databases were systematically searched with relevant search terms in English and German. Of the n = 1492 publications identified, N = 1021 entered the abstract screening and N = 340 full-texts were screened for eligibility. A total of 30 articles, which defined or conceptualized generic health literacy for a target population of 18 years or younger, were selected for a four-step inductive content analysis.ResultsThe systematic review of the literature identified 12 definitions and 21 models that have been specifically developed for children and young people. In the literature, health literacy in children and young people is described as comprising variable sets of key dimensions, each appearing as a cluster of related abilities, skills, commitments, and knowledge that enable a person to approach health information competently and effectively and to derive at health-promoting decisions and actions.DiscussionIdentified definitions and models are very heterogeneous, depicting health literacy as multidimensional, complex construct. Moreover, health literacy is conceptualized as an action competence, with a strong focus on personal attributes, while also recognising its interrelatedness with social and contextual determinants. Life phase specificities are mainly considered from a cognitive and developmental perspective, leaving children’s and young people’s specific needs, vulnerabilities, and social structures poorly incorporated within most models. While a critical number of definitions and models were identified for youth or secondary school students, similar findings are lacking for children under the age of ten or within a primary school context.
BackgroundHealth literacy is an important health promotion concern and recently children and adolescents have been the focus of increased academic attention. To assess the health literacy of this population, researchers have been focussing on developing instruments to measure their health literacy. Compared to the wider availability of instruments for adults, only a few tools are known for younger age groups. The objective of this study is to systematically review the field of generic child and adolescent health literacy measurement instruments that are currently available.MethodA systematic literature search was undertaken in five databases (PubMed, CINAHL, PsycNET, ERIC, and FIS) on articles published between January 1990 and July 2015, addressing children and adolescents ≤18 years old. Eligible articles were analysed, data was extracted, and synthesised according to review objectives.ResultsFifteen generic health literacy measurement instruments for children and adolescents were identified. All, except two, are self-administered instruments. Seven are objective measures (performance-based tests), seven are subjective measures (self-reporting), and one uses a mixed-method measurement. Most instruments applied a broad and multidimensional understanding of health literacy. The instruments were developed in eight different countries, with most tools originating in the United States (n = 6). Among the instruments, 31 different components related to health literacy were identified. Accordingly, the studies exhibit a variety of implicit or explicit conceptual and operational definitions, and most instruments have been used in schools and other educational contexts. While the youngest age group studied was 7-year-old children within a parent-child study, there is only one instrument specifically designed for primary school children and none for early years.ConclusionsDespite the reported paucity of health literacy research involving children and adolescents, an unexpected number of health literacy measurement studies in children’s populations was found. Most instruments tend to measure their own specific understanding of health literacy and not all provide sufficient conceptual information. To advance health literacy instruments, a much more standardised approach is necessary including improved reporting on the development and validation processes. Further research is required to improve health literacy instruments for children and adolescents and to provide knowledge to inform effective interventions.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5054-0) contains supplementary material, which is available to authorized users.
ZusammenfassungDas Konzept der digitalen Gesundheitskompetenz ist das Ergebnis der zunehmenden gesellschaftlichen Durchdringung von digitalen Medien und deren Nutzung im Alltag. Infolge der hohen Zugänglichkeit und Allgegenwärtigkeit von Gesundheitsinformationen steigt die Notwendigkeit nicht nur des Suchens und Findens, sondern insbesondere der Einschätzung ihrer Verlässlichkeit und der darauf bezogenen Selektion und Anwendung für eigene Gesundheitsbelange. Gerade im Kontext der Digitalisierung ist zudem zu berücksichtigen, dass die Nutzenden nicht nur passiv rezipieren, sondern aktiv am Kommunikationsgeschehen durch Interaktion mit bestehenden Inhalten oder durch eigene Informationsbeiträge teilhaben.Der vorliegende Beitrag gibt eine Übersicht über den aktuellen Forschungsstand zur digitalen Gesundheitskompetenz, wobei der Fokus vor allem auf dem Kindes- und Jugendalter liegt. Neben seiner terminologisch-konzeptionellen Verortung und der notwendigen Verschränkung mit dem Ansatz der Medienkompetenzen wird das Verhältnis von digitaler Gesundheitskompetenz und sozialer sowie gesundheitlicher Ungleichheit betrachtet. Als ungleichheitsgenerierend wird dabei weniger der unterschiedliche Zugang zu digitalen Medien angesehen, sondern vor allem die Unterschiede in den zum Umgang notwendigen Kompetenzen. Nach einer Übersicht über die wenigen bisher verfügbaren Instrumente zur Erfassung der digitalen Gesundheitskompetenz werden am Beispiel des Settings Schule erste Überlegungen zu ihrer individuellen und strukturellen Stärkung angestellt.
Background: Health literacy is a determinant of health and assessed globally to inform the development of health interventions. However, little is known about health literacy in countries with one of the poorest health indicators worldwide, such as Afghanistan. Studies worldwide demonstrate that women play a key role in developing health literacy. Hence, this study's purpose is to explore health literacy of women in Afghanistan and the associated factors.Methods: From May to June 2017, we randomly recruited 7–10 women per day at the hospital in Ghazni, a representative province of Afghanistan. Two trained female interviewers interviewed 322 women (15–61 years old) orally in Dari or Pashto on a voluntary basis and assessed their health literacy using the HLS-EU-Q16, associated socio-demographics, and health behavior.Results: Health literacy of women (among educated and illiterates) is low even compared to other Asian countries. Health literacy is linked to age and education. We found mixed evidence of the relationship between health literacy and contextual factors, help-seeking, and health-related behavior.Conclusion: This study provides novel data on health literacy and astonishing insights into its association with health behavior of women in Afghanistan, thus contributing to health status. The study calls for recognition of health literacy as a public health challenge be addressed in Afghanistan and other low-income countries affected by crises.
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