Health Literacy: An Interactive Outcome Among Secondary Students in Beijing

Abstract

Background: Health literacy enables a person to make good decisions regarding health care, disease prevention, and health promotion to maintain and improve health. Although health literacy research in China has gained increasing attention in recent years, most existing studies focus on adults rather than adolescents. In addition, little theory-driven empirical research has been conducted to fully understand the relationship among health literacy, its influencing factors, and health outcomes scored on a skills-based health literacy instrument. Objective: This study applied Manganello's framework to investigate how health literacy was related to its antecedents and health status in secondary students in Beijing, China. Methods: A cross-sectional study was conducted with 650 students in Years 7 to 9 (age 11-17 years) from four secondary schools. Students completed a self-administered questionnaire based on Manganello's health literacy framework, which measured key upstream determinants, including health literacy and self-report health status. Health literacy was measured on an 8-item skills-based instrument that assesses a person's ability to find, understand, appraise, and communicate health information in everyday life (scores range from 0-37). Descriptive statistics and path analysis were conducted to investigate the mediating role of health literacy in predicting health status. Key Results: Overall, the average scores of students' health literacy was 26.37 (±5.89). Manganello's framework was supported by the data collected (χ 2 /df = 2.049, p = .001, comparative fix index = 0.966, root mean square error of approximation = 0.041). Personal self-efficacy (r = 0.11, p = .007), social support (r = 0.18, p < .001), and school environment (r = 0.27, p < .001) predicted health literacy, which in turn predicted students' health status (r = 0.12, p = .005). Conclusions: Adolescent health literacy is not only a person's capability to protect health, but also an interactive outcome with the broader environment. Promoting health literacy could be a useful strategy to improve health status for adolescents; however, a holistic approach is needed to increase students' self-efficacy, promote social support, and create positive school environments to achieve optimal health literacy and health outcomes.

Conceptualization of Health Literacy from a Nursing Perspective

“…Meanwhile, Guo et al (2021) found that sociodemographic factors (gender, education, income, and access to information) were not directly related to health literacy. Social-democratic relationships were observed through personal factors such as self-efficacy, social support, and health status.…”

“…Health literacy is the initial component of obtaining a permanent health culture and optimal health status (Barton et al, 2018). Health literacy allows a person to make a good decisions on health care, disease prevention and health promotion to maintain and improve health (Alsubaie & Salem, 2019;Guo et al, 2021). Adequate health literacy will improve healthy lifestyle behaviours and increase individual capacity to manage disease conditions (Coşkun & Bebiş, 2019; M. T. Kim et al, 2020;Mosley & Taylor, 2017).…”

The Representation of Health Literacy Level in Millennial Adolescents Healthy Living Behaviour

“…Penelitian-penelitian tersebut menunjukkan bahwa literasi kesehatan remaja bukan hanya kemampuan seseorang untuk melindungi kesehatannya, tetapi juga merupakan hasil interaksi dengan lingkungan di luar dirinya (Dudley, Bergen, McMaugh, & Mackenzie, 2018;Shuaijun Guo, Yu, Davis, Armstrong, & Naccarella, 2021). Remaja milenial dengan tingkat ekonomi menengah atas sudah terbiasa bermain dengan gadget, yang menyuguhkan berbagai informasi.…”

Comparison of Health Literacy Assessment Tools among Beijing School-Aged Children

“…The ecological theory highlights that health literacy is not only an individual’s capability to protect and maintain health but also an interactive outcome with the broader environment [ 30 ]. Except for socio-demographics, empirical studies have shown that other intrapersonal, interpersonal and environmental factors are also associated with child health literacy [ 31 , 32 , 33 ]. Examples of these factors are personal self-efficacy [ 33 ], health interests [ 34 ], social support [ 31 ], and school environment [ 35 ], which also influence children’s physical, cognitive, and educational outcomes.…”