Abstract
Although among adolescents with psychosocial problems low health literacy may increase the risk of poor treatment outcomes, the contributing mechanisms within treatment remain unclear. A better understanding of these mechanisms could contribute to improved treatment processes and outcomes. This study aims to examine the relationship between functional health literacy, treatment processes (treatment adherence, learning processes), and treatment outcome (level of psychosocial problems) in adolescents in psychosocial care. We used data from a prospective cohort study among adolescents aged 12–18 (N = 390), collected in four successive measurements: at entry into care, and 3, 12, and 24 months thereafter. We used a mixed effect model to investigate the association between level of functional health literacy (adequate vs. inadequate) and treatment processes (treatment adherence, learning processes) and treatment outcome (level of psychosocial problems). Between adolescents with adequate and inadequate functional health literacy, we found no differences or change over time in adherence or learning processes. The level of psychosocial problems significantly declined over time (β = − 1.70, 95% CI [− 2.72, − 0.69], p = .001) to a similar degree in both groups, though, in all measurements, the level was consistently higher for adolescents with inadequate health literacy. We conclude that health literacy levels did not affect change in treatment processes nor in outcomes of psychosocial treatment. However, the consistently higher level of psychosocial problems among adolescents with inadequate health literacy suggests an unaddressed need in psychosocial care.
Highlights
Psychosocial problems—emotional, behavioural, and social problems—are the third largest contributor to the global burden of disease in adolescents [1,2,3]
We found no association between health literacy level and treatment adherence or learning processes
Levels of psychosocial problems for adolescents with both inadequate and adequate health literacy decreased to a similar degree, but remained higher for adolescents with inadequate health literacy
Summary
Psychosocial problems—emotional, behavioural, and social problems—are the third largest contributor to the global burden of disease in adolescents [1,2,3]. Health literacy is deemed dependent on individual capabilities, such as reading and writing skills, speaking and listening skills, and numeracy [11]. In line with this perspective, the current study focusses on functional health literacy, meaning that the basic literacy skills (i.e., reading and writing) needed in regular health care situations. Adolescent educational level represented the level of current education and not the highest obtained diploma, because most adolescents were still in school. Parental education level was defined by the highest diploma obtained and categorised in the same way as the educational level of the adolescent
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
