Health literacy and adolescents: a framework and agenda for future research

Abstract

Health literacy is an important issue in public health today, especially as patients are taking a greater role in obtaining information about their health. Health literacy is commonly defined as 'the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions'. While there is a large body of literature concerning health literacy and adults, few studies have focused on adolescents. Adolescents may have less interaction with the health care system and lower health care costs than adults, but they are increasingly involved with their health care, especially those with chronic illness. They are frequent users of mass media and other technology to access health information and are a target group for many health-related educational interventions. Adolescents are also at a crucial stage of development, learning skills they will carry with them into adulthood. The goal of this paper is to provide a summary of issues justifying the importance of studying health literacy as it relates to adolescents and to provide a framework and suggestions for future research.

Health literacy as a learning outcome in schools

“… critical thinking skills (Mancuso, 2009; see also Abel, 2007);  media literacy skills (Manganello, 2008;Zarcadoolas et al 2005);  problem-solving skills (Mancuso, 2009);  the ability to gain access to information and knowledge (Abel, 2007;Kickbusch, 2001;Nutbeam, 2008);  motivation (Nutbeam, 2000);  self-efficacy (Nutbeam, 2000);  understanding and personalizing health information one has obtained (Nutbeam, 2008);  appropriately applying relevant health information for personal benefit (Nutbeam, 2008);  understanding the conditions that determine health and knowledge and how to change them (Abel, 2007).…”

The Health Literacy Skills Framework

“…The majority of these frameworks illustrate the effects that health literacy has on health-related outcomes (Lee, Arozullah, & Cho, 2004;Manganello, 2008;Nutbeam, 2000;Paasche-Orlow & Wolf, 2007;Rootman et al, 2002; Schillenger, 2001;von Wagner et al, 2009). However, few illustrate the full continuum of relations among predictors, moderators, mediators, and outcomes of health literacy all in one theory or framework (Pleasant, 2011).…”

“…Some include communication as a component of health literacy (Baker, 2006;Mancuso, 2008;Manganello, 2008;Nutbeam, 2000). The Institute of Medicine includes oral literacy-listening and speaking skills-as a component of the general literacy skills that are necessary for health literacy and is essentially the same as communication skills.…”

“…Whereas some frameworks include morbidity and mortality as outcomes (Nutbeam, 2000), others only consider mediators such as health behaviors and use of health services as outcomes (Sørensen et al, 2012;von Wagner et al, 2009). However, some frameworks include both types of outcomes (Lee et al, 2004;Manganello, 2008;Rootman et al, 2002;Schillinger, 2001;Sørensen et al, 2012).…”

“…There are a variety of models and frameworks that describe factors associated with health literacy skills (Baker, 2006;Mancuso, 2008;Nutbeam, 2000;Paasche-Orlow & Wolf, 2007;von Wagner, Steptoe, Wolf & Wardle, 2009). A comprehensive health literacy theory or framework may spur more professional discussions to help lay the foundation for a new era of theory-driven research.The majority of these frameworks illustrate the effects that health literacy has on health-related outcomes (Lee, Arozullah, & Cho, 2004;Manganello, 2008;Nutbeam, 2000;Paasche-Orlow & Wolf, 2007;Rootman et al, 2002; Schillenger, 2001;von Wagner et al, 2009). However, few illustrate the full continuum of relations among predictors, moderators, mediators, and outcomes of health literacy all in one theory or framework (Pleasant, 2011).…”