Background: Studies conducted in the past mostly rely on models of functional health literacy in adult populations. However, such models do not satisfy the need for health intervention in adolescents. The identification of key factors influencing adolescents' health literacy is essential in developing effective prevention and intervention measures. This study aimed to test a theoretical model of predictors on health skills and health behaviors in adolescents.
Methods: A cross-sectional survey was conducted in Guangdong using a multi-stage stratified cluster sample design. A representative random sample of 3821 students aged 13-25 years was selected using multi-stage stratified cluster sampling. The path analysis was used to test a hypothesized model of health literacy.
Results: The path analysis showed that knowledge of infectious disease (β = 0.26), health skills (β = 0.22), health concept (β = 0.20), general health knowledge (β = 0.15), gender (β = 0.12), and school performance (β = 0.06) had positive direct effect on health behaviors in adolescents. The explanatory variables accounted for 43% of the variance in explaining health behaviors. Knowledge of infectious disease (β = 0.30), health concept (β = 0.17), general health knowledge (β = 0.13), and school performance (β = 0.05) had positive indirect effect on health behaviors through the impacts on health skills.
Conclusion: This study identified several direct and indirect factors influencing health skills and health behaviors in adolescents. These findings will assist health professionals designing effective health interventions that aim to improve health skills and health behaviors in adolescents.