Health literacy, self-reported status and health promoting behaviours for adolescents in Taiwan

Abstract

Aim and objective: The objective of this study was to analyse the associations between health literacy, health status and health-promoting behaviours among Taiwan adolescents.

Background: Limited health literacy is associated with poor health outcomes such as low use of preventive services, poor self-reported health conditions and absence of health-promoting behaviours in adults. However, these factors have not been analysed in adolescents. The associations between health literacy and health outcome in adolescents provide helpful insights in conducting health education programmes for health professionals.

Design: A cross-sectional survey.

Methods: The survey analysed a purposive sample of 1601 senior/vocational high school students from six counties in Taiwan. Data for health literacy and health-promoting behaviours were collected by the Chinese version (short form) of the Test of Functional Health Literacy in Adolescents (c-sTOFHLAd) and health-promoting behaviour scale with subscales for the following health-promoting behaviours: nutrition, exercise, stress management, interpersonal relations, health responsibility and self-actualisation.

Results: Adolescents with low health literacy were less likely to perceive good health status [adjusted odd ratio, (AOR) = 0·59, 95%CI = 0·41-0·86] and less likely to exhibit health-promoting behaviours (AOR = 0·58, 95%CI = 0·39-0·86) than those with high health literacy were, especially in nutrition (AOR = 0·62, 95%CI = 0·43-0·89) and interpersonal relations (AOR = 0·61, 95%CI = 0·43-0·87) subscales. Adolescents with high and low health literacy did not significantly differ in the following health-promoting behaviours: exercise, stress management, health responsibility and self-actualisation.

Conclusion: Health literacy is vital for promoting health in adolescents, especially in the domains of nutrition and interpersonal relations.

Relevance to clinical practice: Health professionals should conduct health literacy assessments for adolescents prior to designing health education programmes for those with low health literacy to develop health literacy skills as to perform health promoting behaviours.