Objectives: To systematically review and synthesize literature on the relationship between health literacy and health behaviors in adolescents. Methods: Searches in PsychInfo, PUBMED/MEDLINE, and Educational Resources Information Center (ERIC) were conducted. Studies were included if they reported original data on the relationship between health literacy and a health behavior in adolescents, were written in English, and the population did not have a chronic illness or disability. Results: Seventeen studies met inclusionary criteria. Definition and measurement of health literacy, and theoretical frameworks varied across studies. Studies investigated the relationship between functional and media health literacy and adolescent health behaviors, thirteen reported significant, linear relationships. Conclusions: The results suggest that there is a meaningful relationship between health literacy and adolescents' health behaviors. To fully understand the role of health literacy in adolescents' health decision-making, future research should use comprehensive definitions and measures of health literacy, and integrate health behavior and adolescent development theoretical frameworks in study design.
While cancer prevention behaviors have been clearly defined, many people do not engage in these risk-reduction behaviors. Factors such as cancer prevention beliefs and limited health literacy may undermine cancer prevention behavior recommendations. This study explored the relationships between cancer prevention beliefs, health literacy, and cancer prevention behaviors. Data were analyzed from the 2013 Health Information National Trends Survey (n = 1675). Regression analyses for four cancer prevention belief (prevention is not possible, cancer is fatal, there are too many recommendations for prevention, everything causes cancer) statements were modeled, including health literacy and sociodemographic variables as predictors. In addition, separate regression analyses predicted four cancer prevention behaviors (fruit and vegetable consumption, physical activity, cigarette smoking) from cancer prevention beliefs, health literacy, and sociodemographic variables. Participants with low health literacy were more likely to hold fatalistic cancer prevention beliefs than those with higher health literacy. Cancer prevention beliefs were related to less fruit and vegetable consumption, fewer days of physical activity, and with being a nonsmoker after controlling for sociodemographic variables. Health literacy was not a significant predictor of cancer prevention behaviors. Given the relationship between health literacy and cancer prevention beliefs, research is needed to ascertain how to empower patients with low health literacy to have a more realistic understanding of cancer.
Objective: Adolescents assume increased responsibility for their health, particularly regarding health decision-making for lifestyle behaviors. Prior research suggests a relationship between health literacy (HL) and health behaviors in adolescents. Yet, the specific role of HL in adolescents' health decision-making is unclear. This study qualitatively explored adolescents' use of HL in their health decision-making. Methods: Six focus groups with adolescents (N = 37, Mage = 16.49, 86% girls) were conducted. Adolescents' responses to questions about their HL use were coded using thematic analysis. Results: Adolescents identified passive and active HL engagement and several individual (eg, future orientation, risk perception) and environmental (eg, access to resources/information, media) factors that influenced their use of HL in health decision-making. Feedback from others, subjective health, and ability to navigate multiple sources of information also determined adolescents' confidence in their HL skills. Conclusions: Our results support expanding the types of HL studied/measured in adolescents and provide insight on how HL can be leveraged to improve adolescents' health decision-making. Though there was no guiding theory for this study, results support using the Information-Motivation-Behavior Skills model to assess the HL/health decision-making relationship in adolescence.
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