Abstract
Health literacy is an asset for and indicator of adolescents’ health and wellbeing, and should therefore be monitored and addressed across countries. This study aimed to develop and validate ...a shorter version of the original 10-item health literacy for school-aged children instrument in a cross-national context, using data from the health behaviour in school-aged children 2017/18 survey. The data were obtained from 25 425 adolescents (aged 13 and 15 years) from seven European countries. Determination was made of the best item combination to form a shorter version of the health literacy instrument. Thereafter, the structural validity, reliability, measurement invariance, and criterion validity of the new 5-item instrument were examined. Confirmatory factor analysis showed a good model fit to the data across countries and in the total sample, confirming the structural validity (CFI = 0.995, TLI = 0.989, SRMR = 0.011, RMSEA = 0.031). The internal consistency of the instrument was at a good level across countries (α = 0.87–0.98), indicating that the instrument provided reliable scores. Configural and metric invariance was established across genders, ages, and countries. Scalar invariance was achieved for age and gender groups, but not between countries. This indicated that the factor structure of the scale was similar, but that there were differences between the countries in health literacy levels. Regarding criterion validity, structural equation modelling showed a positive association between health literacy and self-rated health in all the participating countries. The new instrument was found to be valid and reliable for the purposes of measuring health literacy among adolescents in a cross-national context.
(1) Background: The aim of this study was to explore the associations between health literacy and symptoms for eating disorders among adolescents, taking into consideration age and gender and whether ...this association is mediated by body image. (2) Methods: We used data on 5054 adolescents (mean age = 13.9, 51.7% boys) from the Health Behaviour in School-Aged Children study conducted in 2018 in Slovakia. We used logistic regression models to examine associations between level of health literacy and symptoms for eating disorders mediated by body image. (3) Results: Adolescents with low and medium levels of health literacy had a higher occurrence of reporting two or more symptoms of eating disorders (odds ratio (OR)/95% CI: 2.25/1.78-2.84 and 1.37/1.15-1.65). Adjustment for body image reduced the significance of association between low level of health literacy and symptoms for eating disorders by 26.4%, and association between medium level of health literacy and symptoms for eating disorders by 29.7%. (4) Conclusions: Adolescents who have a low health literacy level were found to have a higher probability of having symptoms for eating disorders, especially when they perceive themselves as fat. The study refers to potential theoretical frameworks for health literacy intervention that may provide guidelines for the intervention design and materials.
(1) Background: There is a need for studies on population-level health literacy (HL) to identify the current state of HL within and between countries. We report comparative findings from 10 European ...countries (Austria, Belgium (Fl), Czechia, England, Estonia, Finland, Germany, Macedonia, Poland, and Slovakia) on adolescents' HL and its associations with gender, family affluence (FAS), and self-rated health (SRH). (2) Methods: Representative data (N = 14,590; age 15) were drawn from the HBSC (Health Behavior in School-Aged Children) study. The associations between HL, gender, FAS, and SRH were examined via path models. (3) Results: The countries exhibited differences in HL means and in the range of scores within countries. Positive associations were found between FAS and HL, and between HL and SRH in each country. Gender was associated with differences in HL in only three countries. HL acted as a mediator between gender and SRH in four countries, and between FAS and SRH in each country. (4) Conclusions: The findings confirm that there are differences in HL levels within and between European countries, and that HL does contribute to differences in SRH. HL should be taken into account when devising evidence-informed policies and interventions to promote the health of adolescents.
Abstract
Background
Health literacy (HL) is an important determinant of health and health behaviours, and there is a need to monitor HL levels among all population groups. It is therefore essential ...to develop instruments to assess HL during childhood and adolescence. The aim of this study was to examine the cross-national measurement invariance of the instrument Health Literacy for School-aged Children (HLSAC) in four European countries.
Methods
The data were collected via standardized self-administered anonymous questionnaires within classrooms in Finland, Poland, Slovakia, and Belgium. There were in total 1468 respondents (aged 13, N = 690; aged 15, N = 778). The HLSAC instrument was used to measure the subjective HL of adolescents in each country. A multigroup confirmatory factor analysis was applied to test measurement invariance.
Results
Configural and metric invariance was established, but scalar invariance did not hold. However, the instrument exhibited high internal consistency (α = 0.85) and showed adequate fit with the data. Moreover, the partial invariance allowed comparison of mean values across the countries in question. There were significant mean value differences between countries and age-groups.
Conclusions
HL mean values (as assessed via the HLSAC instrument) can be compared across countries. The instrument has utility for large-scale international HL studies on adolescents.
The role of supportive environments on health, wellbeing, and longevity has been widely recognized. However, there is no strong empirical evidence on the association between health literacy (HL) as a ...particular health-related competence and neighbourhoods. Therefore, the aim of the study was to assess the association between the features of neighbourhoods and the level of HL competencies of young people from three countries (Czech Republic, Poland, Slovakia). Self-reported data from an international sample of 11,521 students aged 13–15 years participating in the Health Behaviour in School-aged Children Study (HBSC) in the year 2018 were included in the analyses. The level of HL shows a strong positive relationship with family wealth, and a significant relationship is maintained in all studied countries. Both social and structural features of neighbourhoods turned out to have an impact on students’ HL. However, HL is most clearly explained by the school environment. This study confirms the school effect on higher levels of HL competences in adolescents. This indicates the need to invest in schools located in less affluent areas to generally improve the level of education, implement modern health education combined with HL, and strengthen the social and health competencies of students.
School is a place where students spend most of their daytime hours. Previous studies indicate that the class climate significantly affects students in both positive and negative ways. The aim of our ...study is to describe the trends in the psychosocial school environment based on four surveyed years in the Czech Republic.
The trends in perception of school were assessed by the standardised self-reported HBSC questionnaire from data collected in 2002, 2006, 2010, and 2014. The overall sample included 8,530 girls and 8,087 boys. Data was analysed separately by gender and three age categories 11, 13, and 15 years. Trends were calculated using descriptive categories and percentages. To identify factors influencing school likeness we used binominal logistic regression.
Results showed that school satisfaction declines with age both in boys and girls in each of four surveyed periods. Students who do not feel a high level of support from the teacher are more prone to negative perceptions of school. School duties in both genders were perceived to be greater and more stressful in 2014 than in 2002.
Interventions to support the perception of psychosocial school environment via the educational system should, therefore, take the aforementioned variation into account.
Background
: Regular physical activity and doing well in school are important for growing adolescents. In this study, the associations between physical activity and perceived school performance (PSP) ...are examined together.
Methods
: Young adolescents from 42 countries (n = 193,949) in Europe and Canada were examined for associations between self-reported moderate to vigorous physical activity (MVPA) and PSP. Multinominal analyses were conducted with 0 to 2 days of MVPA and below average PSP as reference categories. Adjusted odds ratios and 95% confidence intervals were reported for pooled data and individual countries after controlling for family affluence scale.
Results
: Girls had better PSP than boys, yet more boys participated in daily MVPA than girls. The associations between PSP and MVPA were inverted
U
shaped. The strongest association for very good PSP was among young adolescents who reported 5 to 6 days MVPA (odds ratios = 2.3; 95% confidence interval, 2.1–2.4) after controlling for family affluence scale.
Conclusions
: Young adolescents with average or better PSP took part in at least 3 days of MVPA in a week, suggesting that participating in some MVPA was positively associated with PSP. More days of MVPA in a week, especially for young adolescents with below average PSP, would be beneficial for health and school performance.
Background: Understanding opinions, attitudes and knowledge of schoolchildren regarding eating habits is essential to develop effective preventive measures in this target group. Objective: The aim of ...the study was to find opinions and attitudes of schoolchildren regarding nutrition and related behaviour. Methods: Data were collected in selected elementary schools from April to June 2015. Pupils of 5th (7 girls, 7 boys), 7th (4 girls, 4 boys) and 9th (8 girls, 10 boys) grades debated their opinions and attitudes regarding eating habits during sessions in classrooms and recorded them into worksheets. Qualitative content analysis of the obtained data was performed. Results: Pupils expressed adequate knowledge on healthy eating habits. Attractiveness of sweets is much stronger in comparison to fruits and vegetables. 11 years olds complained about absence of their parents during family mealtime. The main reasons for drinking soft and energy drinks included taste and social motives. Girls were concerned about their body image and mentioned vomiting as a method to reduce body weight. Conclusions: Children possess general principles of healthy eating habits, but they do not implement them in their life. Prevention in nutrition to avoid social-health problems related to unhealthy diet, particularly obesity, should be focused both on children and their parents as role models in development of eating habits.
Purpose
The purpose of this paper is to discuss the findings of an intervention program built on the concept of children’s health literacy, particularly on its citizenship component. This ...intervention program employed the Investigation-Vision-Action-Change model for action-oriented teaching, where children were supported to investigate different health issues that affect them, create visions about desirable changes, and act toward desirable change. The intervention was implemented in the conditions of a post-communist country (Slovakia) where the majority of health education programs are behaviorally oriented, without giving space to children’s own perceptions and decisions. The study seeks to explore whether fostering children’s participation in forming the school environment improves the three selected factors of school well-being, namely, children’s perception of school, their subjective well-being, and violent behavior in school.
Design/methodology/approach
A cluster-randomized controlled trial design was used where ten classes of children aged nine to ten years were randomly assigned to either experimental (n=89) or control group (n=96). The dependent variables were pre- and post-tested using measures drawn from the Health Behavior in School-aged Children study for Slovakia.
Findings
The intervention program was shown to yield empirically robust effects, given the significant improvement in children’s perceptions about school, violent behavior, and their well-being, with medium-to-large effect sizes (Hedges’s g ranging from 0.74 to 0.96).
Originality/value
The present study offers an effective approach to enhance the respect for the children’s views on issues that affect them, particularly within post-communist conditions.
Objectives. The main objective of this study was to explore the views and beliefs of school-aged children on smoking and drinking of alcohol, using a qualitative approach and data of the ...cross-sectional HBSC (Health behaviour in school-aged children) 2013/2014 study. The aim was also to compare the variability of identified views and beliefs in terms of gender and age. Sample and settings. The sample comprised 75 participants from four Slovak elementary schools. The characteristics of the present sample were similar to those of the target population of HBSC study (11-, 13- and 15-years-old children). The research design was based on a qualitative approach using elicitation in a form of prepared worksheets and initial open questions. The data were collected using worksheets and observer's records. Research questions. What are the views and beliefs of school-aged children about the HBSC findings regarding smoking and drinking and what are their recommendations regarding these issues. Data analysis. A qualitative controlled content analysis was carried out. Results. Participants have sufficient information particularly about the various negative impacts of smoking and alcohol use on health and life in general. However, they do not realize their own potential in addressing health risks. The results indicated some specifics in terms of the gender and age. Study limitation. The quantity and quality of the material gained from participants might be affected by their lack of experience with discussion methods and activities aimed at the development of active engagement. Focus groups size.
PDF
