Abstract

Abstract Background Parents with higher levels of education tend to have better abilities in searching and integrating health information, which can ultimately benefit their childreńs health literacy. We aim to analyse the associations between childreńs health literacy and parents’ education in families with school-age children. Methods A total of 735 children (51.7% boys) with a mean of age (SD) of 7.7 (1.2) years old, participated in this study. Childreńs health literacy was measured with the HLS-Child-Q15, which contained 15 items assessing the child's perceived ease or difficulty in finding, understanding, appraising, and applying health information (α = 0.7). A mean of all items was conducted along with a median split (limited and sufficient health literacy). Parents self-reported their education (e.g., primary school, secondary schools and higher education) and family income. Binary regression models were used, adjusting for age and income. Results Boys whose mothers had a higher education degree had lower odds of achieving sufficient health literacy (adjusted odds ratio (aOR)= 0.4, 95% confidence interval (CI)=0.1; 0.9). In contrast, boys whose fathers had a secondary or higher education degree had a significantly higher odds of achieving sufficient health literacy (aOR=2.3 (1.1; 4.7) and 2.9 (1.2; 6.9, respectively), irrespective of their age and income. Conclusions The indirect association between mothers’ education levels and their sons’ health literacy, and the direct association of fathers’ education levels on their sons’ health literacy, could be explained by previous research that has linked a motheŕs education level to the quality of everyday childcare and a fatheŕs education level to the access of higher social positions and resources, that ultimately can be invested in the child's health literacy. Future intervention studies should take into account the important role of fathers in improving childreńs health literacy, mainly in boys. Key messages • Parents with higher levels of education tend to have children with better health literacy. • There are significant associations between parentśeducation and childreńs health literacy, mainly in boys.

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