Children and young people constitute a core target group for health literacy research and practice: during childhood and youth, fundamental cognitive, physical and emotional development processes ...take place and health-related behaviours and skills develop. However, there is limited knowledge and academic consensus regarding the abilities and knowledge a child or young person should possess for making sound health decisions. The research presented in this review addresses this gap by providing an overview and synthesis of current understandings of health literacy in childhood and youth. Furthermore, the authors aim to understand to what extent available models capture the unique needs and characteristics of children and young people.
Six databases were systematically searched with relevant search terms in English and German. Of the n = 1492 publications identified, N = 1021 entered the abstract screening and N = 340 full-texts were screened for eligibility. A total of 30 articles, which defined or conceptualized generic health literacy for a target population of 18 years or younger, were selected for a four-step inductive content analysis.
The systematic review of the literature identified 12 definitions and 21 models that have been specifically developed for children and young people. In the literature, health literacy in children and young people is described as comprising variable sets of key dimensions, each appearing as a cluster of related abilities, skills, commitments, and knowledge that enable a person to approach health information competently and effectively and to derive at health-promoting decisions and actions.
Identified definitions and models are very heterogeneous, depicting health literacy as multidimensional, complex construct. Moreover, health literacy is conceptualized as an action competence, with a strong focus on personal attributes, while also recognising its interrelatedness with social and contextual determinants. Life phase specificities are mainly considered from a cognitive and developmental perspective, leaving children's and young people's specific needs, vulnerabilities, and social structures poorly incorporated within most models. While a critical number of definitions and models were identified for youth or secondary school students, similar findings are lacking for children under the age of ten or within a primary school context.
Health literacy is an important health promotion concern and recently children and adolescents have been the focus of increased academic attention. To assess the health literacy of this population, ...researchers have been focussing on developing instruments to measure their health literacy. Compared to the wider availability of instruments for adults, only a few tools are known for younger age groups. The objective of this study is to systematically review the field of generic child and adolescent health literacy measurement instruments that are currently available.
A systematic literature search was undertaken in five databases (PubMed, CINAHL, PsycNET, ERIC, and FIS) on articles published between January 1990 and July 2015, addressing children and adolescents ≤18 years old. Eligible articles were analysed, data was extracted, and synthesised according to review objectives.
Fifteen generic health literacy measurement instruments for children and adolescents were identified. All, except two, are self-administered instruments. Seven are objective measures (performance-based tests), seven are subjective measures (self-reporting), and one uses a mixed-method measurement. Most instruments applied a broad and multidimensional understanding of health literacy. The instruments were developed in eight different countries, with most tools originating in the United States (n = 6). Among the instruments, 31 different components related to health literacy were identified. Accordingly, the studies exhibit a variety of implicit or explicit conceptual and operational definitions, and most instruments have been used in schools and other educational contexts. While the youngest age group studied was 7-year-old children within a parent-child study, there is only one instrument specifically designed for primary school children and none for early years.
Despite the reported paucity of health literacy research involving children and adolescents, an unexpected number of health literacy measurement studies in children's populations was found. Most instruments tend to measure their own specific understanding of health literacy and not all provide sufficient conceptual information. To advance health literacy instruments, a much more standardised approach is necessary including improved reporting on the development and validation processes. Further research is required to improve health literacy instruments for children and adolescents and to provide knowledge to inform effective interventions.
Zusammenfassung
Das Konzept der digitalen Gesundheitskompetenz ist das Ergebnis der zunehmenden gesellschaftlichen Durchdringung von digitalen Medien und deren Nutzung im Alltag. Infolge der hohen ...Zugänglichkeit und Allgegenwärtigkeit von Gesundheitsinformationen steigt die Notwendigkeit nicht nur des Suchens und Findens, sondern insbesondere der Einschätzung ihrer Verlässlichkeit und der darauf bezogenen Selektion und Anwendung für eigene Gesundheitsbelange. Gerade im Kontext der Digitalisierung ist zudem zu berücksichtigen, dass die Nutzenden nicht nur passiv rezipieren, sondern aktiv am Kommunikationsgeschehen durch Interaktion mit bestehenden Inhalten oder durch eigene Informationsbeiträge teilhaben.
Der vorliegende Beitrag gibt eine Übersicht über den aktuellen Forschungsstand zur digitalen Gesundheitskompetenz, wobei der Fokus vor allem auf dem Kindes- und Jugendalter liegt. Neben seiner terminologisch-konzeptionellen Verortung und der notwendigen Verschränkung mit dem Ansatz der Medienkompetenzen wird das Verhältnis von digitaler Gesundheitskompetenz und sozialer sowie gesundheitlicher Ungleichheit betrachtet. Als ungleichheitsgenerierend wird dabei weniger der unterschiedliche Zugang zu digitalen Medien angesehen, sondern vor allem die Unterschiede in den zum Umgang notwendigen Kompetenzen. Nach einer Übersicht über die wenigen bisher verfügbaren Instrumente zur Erfassung der digitalen Gesundheitskompetenz werden am Beispiel des Settings Schule erste Überlegungen zu ihrer individuellen und strukturellen Stärkung angestellt.
After years of military interventions, the current situation in Afghanistan is highly ambivalent and partially contradictory - especially regarding the interplay of development, peace, security, ...education, and economy. Despite numerous initiatives, Afghanistan is still confronted with a poor security and economic condition. At the same time, enrollment numbers in schools and universities as well as the rate of academics reached a historical peak.This volume investigates the tension between these ambivalent developments. Sociologists, political and cultural scientists along with development workers, educators, and artists from Germany and Afghanistan discuss the idea that education is primary for rebuilding a stable Afghan state and government.
Health literacy is a determinant of health and assessed globally to inform the development of health interventions. However, little is known about health literacy in countries with one of the poorest ...health indicators worldwide, such as Afghanistan. Studies worldwide demonstrate that women play a key role in developing health literacy. Hence, this study's purpose is to explore health literacy of women in Afghanistan and the associated factors.
From May to June 2017, we randomly recruited 7-10 women per day at the hospital in Ghazni, a representative province of Afghanistan. Two trained female interviewers interviewed 322 women (15-61 years old) orally in Dari or Pashto on a voluntary basis and assessed their health literacy using the HLS-EU-Q16, associated socio-demographics, and health behavior.
Health literacy of women (among educated and illiterates) is low even compared to other Asian countries. Health literacy is linked to age and education. We found mixed evidence of the relationship between health literacy and contextual factors, help-seeking, and health-related behavior.
This study provides novel data on health literacy and astonishing insights into its association with health behavior of women in Afghanistan, thus contributing to health status. The study calls for recognition of health literacy as a public health challenge be addressed in Afghanistan and other low-income countries affected by crises.
Issue addressed
While multiple studies worldwide reveal the strong impact of various determinants on health literacy, empirical data on the link between health literacy and other important dimensions ...of health equity (such as quality of life, beliefs and health literacy in crisis‐affected religious countries such as Afghanistan) is scarce. To inform and develop promising health promotion for people in need, we analysed the relationship between health literacy, quality of life and spiritual and religious beliefs.
Methods
In this first study on health literacy in Afghanistan, we interviewed 522 men and 324 women in the Ghazni province. Besides the HLS‐EU‐16, we used Quality of Life (WHO‐QoL‐BREF) and the WHO‐SRPB‐BREF questionnaires in Dari and Pashto. We performed descriptive, uni‐ and multivariate analyses.
Results
The levels of HL, QoL and SRPB_coping are comparatively low among Afghan men from the Ghazni province, but higher among women on all scales. HL and QoL are positively associated with education and negatively with age (in the female subsample). HL and QoL show a moderate correlation among women but not among men. We found mixed results for the relationship between SRPB and HL or QoL.
Conclusions
The study highlights that health literacy is not a singular factor but related to wellbeing.
So What?
Health education might be promising while combining health literacy to the idea of quality of life of everyone, even those living in poor and illiterate environments.
The concept of digital health literacy can be regarded as the result of the increasing social permeation of digital media and their use in everyday life. Due to increasing accessibility and ubiquity, ...there is an increasing need not only for searching and finding, but especially for assessing the reliability as well as selecting and applying health information for one's own health concerns. In the context of digitization, it needs to be emphasized that users are not just passive recipients, but rather actively participate in the communication process by interacting with existing content or by sharing their own health-related information.With particular focus on children and adolescents, this paper provides an overview of the current state of research on digital health literacy. In addition to its terminological and conceptual foundations and its links with media literacy, the relationship between digital health literacy and social and health inequality is discussed. Inequalities are not only generated by access to digital media but, above all, by the skills required for their use. After an overview of available instruments is provided, initial reflections on how to promote the individual and structural dimension of digital health literacy with focus on school settings is given.
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