Abstract
Health literacy was identified as an important determinant of health, particularly for adolescents. However, more efforts are needed to monitor this construct and provide inputs for policy development. This study aims to: (a) Assess the validity and reliability of the Italian version of the Health Literacy for School-Aged Children (HLSAC-I); (b) Identify the health literacy levels among Italian students and compare them with other countries’ levels; and (c) Identify the associations between health literacy and multiple social determinants (social stratifiers, family, and school connectedness). Data came from the Health Behaviour School-Aged Children survey, carried out in the Lombardy region in northern Italy in 2018. A representative sample of 2,287 13- and 15-year-old Lombardian students was involved. The results support the validity and reliability of the HLSAC-I. A total of 18.7% of the sample reported low levels, and only 6.8% reported high levels. Italian students reported the lowest levels of health literacy compared with other countries. School connectedness and educational approach are the most relevant associated factors. This study confirms a school’s role in reducing inequalities and promoting health. It highlights the importance of monitoring health literacy and implementing health promotion policies at school through a whole-school approach.
Highlights
In recent years, the World Health Organization (WHO) and other international bodies have emphasized health literacy as an important determinant of health [1,2,3,4]
This study has underscored the importance of monitoring adolescent health literacy
We validated the Italian version of the Health Literacy for School-Aged Children scale (HLSAC-I) [41,43,44] used in the Health Behaviour in School-Aged Children (HBSC) study
Summary
The World Health Organization (WHO) and other international bodies have emphasized health literacy as an important determinant of health [1,2,3,4]. Research in this area has increased to expand knowledge of the effects of health literacy, the elements that can promote it, and the most effective strategies to improve it [5]. Critical health literacy describes the more developed cognitive and social skills that make a person able to critically analyse health-related information that is drawn from multiple sources and to use it to exert greater control over both one’s own health decisions and the external influences on those decisions. Critical health literacy includes a healthy citizenship that empowers people to join social and political processes and to modify the determinants of health [1,8,9,10]
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