Health Literacy In Children Research Articles

Health Literacy and Health Outcomes Among Children With Developmental Disabilities: A Systematic Review.

Developmental disabilities (DDs) are prevalent and associated with health disparities among children. Family health literacy of parents and/or children is one modifiable factor associated with child health; however, little is known about family health literacy for children with DDs. This systematic review was conducted to determine evidence on associations of health literacy with health outcomes among children with DDs. Medline, CINAHL, Embase, ERIC, PsycInfo, and Web of Science were searched through August 2018. Of 2,768 unique records, 53 full text articles were reviewed and four articles were included. Associations of family health literacy with health outcomes among children with DDs were mixed. Future research should include more diverse samples, greater breadth in health outcomes assessed, and increased methodological rigor.

Individuelle Gesundheitskompetenz von Lehrkr\xe4ften und deren (Un)Sicherheit im Umgang mit chronisch erkrankten Schulkindern und Notfallsituationen

ZusammenfassungHintergrundGesundheitskompetenz (GK) gilt als eine Schlüsseldeterminante im Hinblick auf die Gesundheitssicherung. Die Förderung von GK sollte so früh wie möglich beginnen, um späteren Gesundheitsrisiken vorzubeugen. Im Setting Schule haben Lehrkräfte hierbei eine zentrale Rolle, denn sie werden durch den Ganztagsschulbetrieb sowie die Inklusionsbestrebungen immer häufiger mit Gesundheitsproblemen Heranwachsender konfrontiert. Gleichwohl kann festgestellt werden, dass eine Vielzahl der Lehrkräfte selbst erhebliche Gesundheitsprobleme aufweist, u. a. bedingt durch hohe Arbeitsbelastungen.FragestellungIn dieser Arbeit wird das Niveau der GK von Lehrkräften ermittelt und ein möglicher Zusammenhang zwischen individueller GK der Lehrkräfte und deren Sicherheit im Umgang mit chronisch erkrankten Schulkindern untersucht.MethodenEs erfolgte eine Sekundärdatenanalyse von Daten aus einer quantitativen Befragung von n = 420 Lehrkräften. Zur Selbsteinschätzung ihrer GK wurde der „European Health Literacy Survey Questionnaire“ (HLS-EU-Q16) verwendet. Weiterhin erfolgten Korrelationsanalysen zwischen der GK und dem Grad der Unsicherheit im Umgang mit ausgewählten Gesundheitsproblemen.ErgebnisseMehr als die Hälfte der Befragten weist eine eingeschränkte GK auf. Gleichzeitig ist ein deutlicher Zusammenhang zwischen GK und der Sicherheit im Umgang mit chronisch erkrankten Schüler/‑innen festzustellen. Insbesondere im Umgang mit psychischer Gesundheit bestehen Unsicherheiten.DiskussionEs besteht eine Diskrepanz zwischen den Anforderungen an die Lehrkräfte im Hinblick auf die Bewältigung von Gesundheitsproblemen im Setting Schule und ihrer dafür benötigten Gesundheitskompetenz und Souveränität im Umgang mit chronischen und psychischen Beeinträchtigungen. Die genannten Aspekte können einen Einfluss auf die kindliche GK sowie die gesundheitliche Entwicklung der Heranwachsenden nehmen.

Adapting the European Health Literacy Survey Questionnaire for Fourth-Grade Students in Germany: Validation and Psychometric Analysis.

Background:Until now, children younger than age 13 years have received little attention in research on health literacy. Although some tools assess children's health literacy, no validated tool is available that assesses self-reported health literacy in a systematic and comparable way. The European Health Literacy Survey Questionnaire (HLS-EU-Q) is a valid and reliable measure of adults' self-reported health literacy. It has also been used among adolescents, but it has never been adapted for use with children. We believe it would be worth adapting for younger age groups so that self-reported health literacy could be assessed continuously.Objective:This study aimed to quantitatively test an adapted scale based on the HLS-EU-Q developed for German-speaking children age 9 and 10 years.Methods:An adapted 26-item HLS-EU-Q scale was given in a paper-and-pencil survey to 907 fourth-grade students in North Rhine-Westphalia, Germany. The psychometric properties of the scale were investigated with item analysis and factor analyses, and both convergent and discriminant validity were assessed.Key Results:Of the 26 tested items, 9 were discarded due to poor performance in terms of missing values, item difficulty, and factor structure. This left a 15-item scale with a high internal consistency (α = .791) that takes only a short time to administer. The scale, called the HLS-Child-Q15, had a low correlation with functional health literacy (r = .107, p < .001), and a moderate correlation with indicators of self-efficacy (ρ = .280 to .306, p < .001). The latter indicates adequate discriminant validity, whereas the former points to a need to further investigate convergent validity.Conclusions:This is the first study to apply an age-adapted version of the HLS-EU-Q to children. Statistical analyses indicated the successful development of a promising instrument, but further research is needed on its factor structure and validity. This study contributes significantly to the comparative assessment of health literacy across the life course by providing a measurement tool for children age 9 and 10 years. [HLRP: Health Literacy Research and Practice. 2020;4(3):e144–e159.]Plain Language Summary:The European Health Literacy Survey Questionnaire was adapted for German-speaking 9- and 10-year-old children, and 26 adapted items were tested in a written survey of 907 children. Item analysis resulted in a 15-item scale with satisfactory psychometric properties. This scale, the HLS-Child-Q15, shows high internal consistency and can be used to assess self-reported health literacy in German-speaking 9- and 10-year-old children. Nonetheless, further studies are needed to validate these results.

Testing a school-based program to promote digital health literacy and healthy lifestyle behaviours in intermediate elementary students: The Learning for Life program.

Promoting digital health literacy and healthy lifestyle behaviours in children can lead to positive long-term health outcomes and prevent chronic diseases. However, there are few school-based interventions promoting this education to intermediate elementary students. The objective of this study was to test the effectiveness of a novel intervention to increase students' digital health literacy and health knowledge. Learning for Life is a classroom-based education program, developed for grade 4-7 students and delivered by teachers over six weeks. Three Canadian schools were recruited to deliver the intervention in 2018. This study had a pre-post design and no control group. Students' self-reported digital health literacy and healthy lifestyle behaviours were measured at pre-intervention (n=126), post-intervention (n=119), and two-month follow-up (n=104). Students at pre-intervention had a mean (SD) age of 10.98 (0.56) years (57.1% females). Almost all (97%) students had unsupervised access to the Internet through a computer or smartphone. From pre- to post-intervention, students' digital health literacy increased (p=0.009), but decreased from post-intervention to follow-up (p<0.001). Post-intervention, the majority of students could identify at least one healthy behaviour (e.g., exercising one hour/day) and reported making at least one healthy change in their lives (e.g., eating more fruits/vegetables). This study demonstrated that the Learning for Life intervention can improve intermediate elementary students' digital health literacy over the short-term and help them learn and retain healthy lifestyle knowledge and behaviours. These findings affirm the need for interventions promoting digital healthy literacy and healthy lifestyle behaviours for this age group.

Health Literacy and Predictors of Body Weight in Turkish Children

PurposeThis study assessed the association between health literacy (both of children and their parents) and body weight in Turkish schoolchildren. This study also aimed to determine the predictors of body weight in children. Design and methodsThis was a descriptive, correlational study that enrolled students and their parents from Turkish secondary schools. Data were collected using the Health Literacy Scale for School-Aged Children, Adult Health Literacy Scale, socio-demographic questionnaires and anthropometric measurements. ResultsThe mean child age was 12.76 ± 1.27; 40.2% were male, 41.5% had higher health literacy and 17.2% were obese. Child health literacy did not correlate with body mass index (r = 0.04, p > 0.05), but correlated positively with parent health literacy (r = 0.17, p < 0.05). Parent body mass index was the only explanatory variable in child body mass index. ConclusionsObesity in schoolchildren correlates with parental obesity. The results showed parents should participate in practising strategies that aim to prevent and treat childhood obesity. Practice implicationsChildren's health literacy skills can be improved to develop their health and academic achievements.

Integrating Health Literacy Into Core Curriculum: A Teacher-Driven Pilot Initiative for Second Graders.

Limited research has addressed the effects of health literacy interventions in elementary schools. However, school-aged children's health literacy is critical because children make decisions about their health every day. The purpose of the pilot project was to explore the feasibility of integrated health literacy lesson plans for second graders. A pretest-posttest evaluation was conducted with second grade students following implementation of health literacy lessons that were integrated into core curriculum (language arts, science, and social studies). Health educators, a hospital/health care system, and a school district developed a partnership. A research team of teachers, administrators, health literacy experts and health care organizations designed and implemented health literacy lesson plans. A developmentally appropriate measure of health literacy was adapted from the Newest Vital Sign. Data showed that students' health literacy scores significantly increased after implementation of 4 lesson plans. This was an exploratory, pilot project that provided a useful starting point for discussing how to integrate health literacy into elementary school curriculum. An interdisciplinary team developed integrated health literacy materials that acknowledged the needs of teachers, the resources available, and the developmental stages of children. This intervention serves as a model for future health literacy initiatives in schools.

ORAL HEALTH LITERACY OF PARENTSAND ASSOCIATION WITH CHILDREN ORAL HEALTH STATUS – A REVIEW

Oral health literacy (OHL) is the capacity of the individual to gain, practise and to recognise the information on basic health and its services required for appropriate oral health (OH)conclusions. The OHL allows an individual to move relatively through the health care system rather allowing them to write , read and relate the literature on oral health. It is an important section of physical health and comfort, even more than a clean mouth, a great smile, and relief from pain and infection. It also relates significantly to self-esteem and personal achievement. There is enough evidence in the literature with several studies which reveals that the oral health literacy is significantly associated with adult’s oral health status, as well as children’s oral health

Adapting the European Health Literacy Survey for Fourth-Grade Students in Germany: Questionnaire Development and Qualitative Pretest.

Background:Promoting health literacy in early life is regarded as an important means of sustaining health literacy and health over the life course. However, little evidence is available on children's health literacy, partly due to a scarcity of suitable measurement tools. Although there are 18 tools to measure specific items of health literacy for people younger than age 13 years, there is a lack of comparable, valid, and age-appropriate measures of generic health literacy.Objective:This study aimed to develop and qualitatively test an age-adapted version of the European Health Literacy Survey Questionnaire (HLS-EU-Q) for German-speaking children age 9 and 10 years. Although validated for adults and adolescents, the HLS-EU-Q has never been age-adapted or used with children.Methods:The content and language of HLS-EU-Q items were adapted for this age range. The literature was consulted to inform this process, and adaptations were developed and selected based on consensus among authors. From an item pool of 102 adapted items, 37 were given to 30 fourth-grade students in a cognitive pretest, which is a standard procedure in questionnaire development aiming to explore how items are interpreted. Participants (18 girls, 12 boys) were mostly age 9 or 10 years (range, 9–11 years).Key Results:Problems with misinterpretation were identified for some items and participants (e.g., items designed to assess participants' perceived difficulty in accessing and appraising health information were partly answered on the basis of knowledge and experience). A final selection of 26 well-performing items corresponded to the underlying HLS-EU-Q framework.Conclusions:This is the first age-adapted version of the HLS-EU-Q. A preliminary 26-item questionnaire was successfully developed that performed well in a cognitive pretest. However, further research needs to verify its validity and reliability. The present findings help to advance the measurement of generic self-reported health literacy in children and highlight the need for cognitive pretesting as an essential part of questionnaire development. [HLRP: Health Literacy Research and Practice. 2020;4(2):e119–e128.]Plain Language Summary:The European Health Literacy Survey Questionnaire is used for testing adults' health literacy. It was adapted for German-speaking children age 9 and 10 years. Based on a review of the original items and the literature, 26 questionnaire items were developed and tested in interviews with 30 children. Although problems with understanding could be identified, the questionnaire was mostly well understood.

Potentials of School Nursing for Strengthening the Health Literacy of Children, Parents and Teachers.

Health literacy (HL) plays a key role in explaining health disparities. School nurses (SN) provide health related expertise within the school setting. A positive effect on the HL of children but also their teachers and parents has been suggested by some research, but gaps persist in the available information. As a pilot project, SN, which are not common in German schools, were placed in 28 public elementary and secondary schools in two German states. Children (11+ years, n = 2773), parents (n = 3978) and teachers (n = 420) participated in a 2017 baseline (T0) survey. Data collection was repeated in 2018 (T1). HL was measured using the Health Literacy for School-Aged Children scale (HLSAC) (children) and the European Health Literacy Short Scale (HLS-EU-Q16) (adults). Descriptive and multivariate data analyses were carried out. The HL of all groups increased between T0 and T1. Low child HL decreased from 17.9% to 14.9%. Problematic and inadequate HL dropped from 43.8% to 38.8% among parents and from 49.9% to 45.8% among teachers. Improvements were significant for children and parents but not for the teachers. Despite the relatively short intervention period and a relatively non-specific spectrum of interventions, there is some evidence that SN may contribute to strengthening HL within the school setting. The longer-term effects of SN on health literacy and child health should be further examined. For this, a clearer conceptualization of the scope of work of the SN in Germany including their educational interventions is imperative.

Topical Review: Proposing a Developmentally Informed Research Agenda for the Study of Health Literacy in Children.

Topical Review: Proposing a Developmentally Informed Research Agenda for the Study of Health Literacy in Children.

Potentials of school nursing for strengthening health literacy: a 2017/18 German longitudinal survey

Abstract Background Health literacy (HL) plays a key role in explaining health disparities. School nurses provide health related expert knowledge and skills within the school setting. A positive effect on the HL of children but also their teachers and parents is assumed and supported by some research but gaps persist in the available data. Methods As part of a pilot school nursing project, which placed school nurses in 28 public schools in two German states, all teachers, parents and students (11+ years) attending the schools were invited to participate in a 2017 baseline (T0) and 2018 follow-up (T1) survey. Adult HL was measured using the HLS-EU-Q16 and child HL with the HLSAC. Bi- and multivariate analyses were carried out. Results Comparing T0 and T1, HL scores improved in all populations. In East Germany (Brandenburg), the percentage of teachers with problematic or inadequate HL decreased from 56.6 (N = 173) to 51.5 (N = 173) and among parents from 45.7 (N = 1719) to 43.2 (N = 1080). In West Germany (Hessen), the percentage of teachers with problematic or inadequate HL also decreased, from 43.7 (N = 201) to 42.2 (N = 263), and among parents from 42.2 (N = 2013) to 34.9 (N = 1251). The percentage of children that scored in the moderate or high HL brackets increased from 77.9 (N = 898) to 82.2 (N = 736) in Brandenburg and from 84.9 (N = 1379) to 86.5 (N = 1487) in Hessen. There were strong statistical relationships between child/parental HL and child health behaviors in all datasets. The T0 and T1 comparison showed some improvements over time. The presence of school nurses in public schools seemed to increase health awareness, thus contributing to a “healthy school.” After a short period (18 months) and despite a rather nonspecific spectrum of interventions, the HL of all relevant target groups improved. Further research is needed to quantify the relative contribution of the school nurses to improvements in HL, for example, by implementing a HL curriculum in a controlled setting. Key messages The presence of a school nurse seemed to increase health awareness contributing to a “healthy school.” After 18 months of intervention, the health literacy of children, parents and teachers improved.

Parental health literacy and health behaviors in children: a 2017 cross-sectional survey in Germany

Abstract Background Health literacy (HL) is closely associated with leading health indicators. Parents represent a critical subgroup among the adult population since they are not only responsible for their own health but also for the health of their children. Previous research suggests that parents with low HL are less likely to meet the preventive and health care needs of their children but the relationship between parental HL and child health is not yet well understood. Methods A cross-sectional survey was implemented in 2017 in 28 public schools in Germany. The parent questionnaire was completed by 4217 caregivers and included the short form of the HLS-EU-Q16. The child questionnaire examined health knowledge, behaviors and outcomes. For children under 11 years, the caregiver reported on behalf of their children (N = 1518). In all other cases, the children completed the questionnaires (N = 2776). Bivariate and multivariate analyses were carried out. Results Among the interviewed parents, 45.8% showed a problematic or inadequate HL. Parents with higher HL reported a better subjective health and quality of life, and they judged their children as being healthier. The major determinant of high parental HL was socio-economic status (r=.088***). High parental HL was associated with positive health behaviors in children including higher consumption of fruits and vegetables, fewer sweetened beverages, regular tooth brushing and more physical activity. The relationships between parental HL and smoking, alcohol consumption, sexual activity among children and children’s weight were not significant. Conclusions The results confirm a relationship between low parental HL, SES and some problematic health behaviors in children. Strengthening the HL of vulnerable parents may contribute to improved health outcomes particularly in the areas of children’s nutrition, exercise and dental health, and parents should be integrated in school-based activities of health promotion and prevention. Key messages There is a strong statistical relationship between parental health literacy and socio-economic status. Parental health literacy is associated with child health behaviors (e.g., nutrition, exercise).

Round table: Health literacy and life skills: children and adolescents’ tools for health promotion

Abstract This round table aim is to explore transculturality of methods and instruments to assess Health Literacy (HL) and Life Skills (LS) in Childhood and Adolescence and integrate this discussion in the overall context of HL research in the European context. HL and LS focuses on the knowledge and skills that enable people to access, understand, evaluate and apply information in order to make health decisions and promote health and well-being. While research in the past focused basically on adults, HL &amp; LS research in children and adolescents is a novel field of study. Specific study cases from France and Portugal will help frame the discussion. The CrAdLiSa (developing ChildRen and ADolescents’ health Literacy) research project is focused on exploring the usability of previous tools and instruments - already implemented in other European countries - to evaluate the feasibility of their cultural adaptation and validation. The research focuses on a public health perspective addressing qualitative, quantitative, and intervention research in context of health literacy (HL) and Life Skills (LS) and e-HL of children, adolescents, and professionals working in education, health, and social care settings. Following the track left by Nairobi (2009) and the Shangai declarations (2016) HL has evolved into a significant public health and health promotion goal which has been included to several public health policies (eg. in Portugal, the General Health Directorate of Health (GHDH), established its first policy that focused on children and adolescents HL PNSE|2015, 8815/2015 DR, II, n° 154, 10-08-2015). Present first time empirical findings and developments of these projects and open the floor for further discussion. On top of this, LS will be addressed from the methodological perspective. Thereby, it will shed light on the HL and LS of children and adolescents and link the current debate with contemporary public health approaches to advance the field of HL and LS in childhood and adolescence. The round table will include 3 presentations with up to 15 minutes input followed by discussion. The first presentation is a theory-driven project about developing a conceptual LS model adaptation for children and adolescents in France. The second will introduce a HL questionnaire and its validation data from a pilot study in 4th grade (9-10 y.o.). The third presentation will explore findings of a pilot study by using a HL measure in children (9-10 y.o.) and the relationship between functional HL and subjective health. This round table offers a forum for researchers, practitioners and policy-makers interested in HL and health promotion. By dialogue and two-way communication lively interaction and vivid discussions will be facilitated. This will allow discussing results regarding their benefit for improving HL research, practice, and policy-making, support further synergies, facilitate networking and collaboration, and support international capacity building. Key messages There is need for empirical health literacy and life skills research in children and adolescents. A more broad discussion needs to be developed regarding concepts, instruments and strategies for health literacy and life skills promotion.

Subjective Health Literacy among School-Aged Children: First Evidence from Lithuania.

Health literacy as a set of competencies to promote and sustain health has received significant research attention, particularly in studies on adults. Improving health literacy at an early age is crucial to personal health and development, so there is a need to investigate the health literacy of school-aged children. The aims of this study were to determine the level of subjective health literacy among adolescents in Lithuania and to examine the association between health literacy, school achievement, health education in schools, and family affluence. Health literacy was assessed using a brief Health Literacy for School-Aged Children instrument on a representative sample of 2369 subjects (from the 7th to 10th grades). Overall, 12.1% of all respondents had low, 70.5% moderate, and 17.4% a high level of health literacy. School achievements were found to be a significant predictor of health literacy, as were the number of school-based health promotion events. Family affluence also predicted an increased level of health literacy. This study was the first nationally representative examination of this topic in Lithuania and it highlighted the alarming finding that less than one-fifth of adolescents had high health literacy.

Child and Youth Health Literacy: A Conceptual Analysis and Proposed Target-Group-Centred Definition.

(1) Background: This article adopts an interdisciplinary perspective to analyse, examine, and reflect upon prominent health literacy (HL) understandings in childhood and youth. (2) Method: The conceptual analysis combined Rodgers’ and Jabareen’s approaches to conceptual analysis in eight phases. (3) Results: First, we present exploratory entry points for developing a child-specific HL understanding based on the six dimensions of a ‘health-literacy 6D model’. Second, we describe and reflect upon five meta-level dimensions covering the HL definitions and models for children and youth found in the conceptual analysis. Third, we integrate our findings into a target-group-centred HL definition for children and youth. (4) Discussion/Conclusion: This article raises awareness for the heterogeneity of the current conceptual HL debate. It offers a multidisciplinary approach for advancing the existing understanding of HL. Four recommendations for future actions are deduced from the following four principles, which are inherent to the proposed target-group-centred HL definition: (a) to characterize HL from an asset-based perspective, (b) to consider HL as socially embedded and distributed, (c) to recognize that HL develops both in phases and in flexible ways, and (d) to consider the multimodal nature of health-related information. Further research is necessary to test the feasibility and applicability of the proposed definition and conceptual understanding in both research and practice.

'If I knew what was going to happen, it wouldn't worry me so much': Children's, parents' and health professionals' perspectives on information for children undergoing a procedure.

Children undergoing procedures such as blood tests and X-rays experience less anxiety and upset if they are well prepared and informed. Currently the provision of information about procedures can be ad hoc and there are barriers to children understanding this information. This study explored the perspectives of 32 children undergoing procedures (aged between 8 and 12 years), 27 parents and 19 health professionals on the provision of preparatory information to children. Qualitative interviews, prompted by visual images, were thematically analysed. The three themes, 'accessing information', 'understanding information' and 'using information', resonated with the central tenets of health literacy. Children reported mainly accessing information second-hand through their parents and demonstrated misconceptions about their procedure. Children identified that procedural information would help them to know what was going to happen and enable them to feel less worried and scared about their procedure. This study highlights that children can have low levels of health literacy in relation to a planned procedure. Their health literacy in this context is heavily influenced by the adults (parents and health professionals) around them. There needs to be further work conducted, informed directly by children, to improve the health literacy of children attending hospital for planned procedures.

Improving mental health literacy among young people aged 11\u201315\u2009years in Java, Indonesia: co-development and feasibility testing of a culturally-appropriate, user-centred resource (IMPeTUs) \u2013 a study protocol

BackgroundDepression and anxiety are two of the leading causes of disease burden in low-to-middle income coutnries. The World Health Organisation has engaged in a programme of scaling-up mental health services, but significant challenges remain. Improving mental health literacy in children and young people, a core part of recent, global health strategies has the potential to address some of these challenges. The study aims to co-develop and feasibility test, a culturally-appropriate toolkit to promote depression and anxiety focused mental health literacy and self-management skills in Indonesia, for children aged 11–15 years.MethodsA mixed methods study comprising four phases. Through a systematic review of existing evidence, phase 1 will review approaches to improve mental health literacy and self-management in South East Asia and critically review current evidence regarding intervention effect. Phase 2 will explore stakeholders’ views on depression, anxiety and mental health more broadly and identify priorities for the intervention through the use of semi-structured interviews and/or focus groups with policy makers, clinicians, teachers, adolescent service users, carers and young people aged 11–15. Phase 3 will comprise iterative workshops with local stakeholders to present our findings and co-produce a testable, culturally appropriate toolkit to promote mental health literacy and depression/anxiety focused self-management in 11–15 year olds in Java, Indonesia. Phase 4 comprises feasibility evaluation of our developed intervention via nine in-depth case studies (Jakarta, Bogor and Magelang). We will examine the impact, acceptability and feasibility of our prototype intervention and produce evidence-based guidelines for wider implementation.DiscussionTools to support mental health literacy and self-management are a low cost way in which mental health services in LMICs can attempt to address the burden of anxiety and depression amongst children and young people. However, this is an underexplored area in Indonesia. Working closely with local stakeholders, this study will design and undertake feasibility evaluation of co-produced mental health literacy and anxiety and depression focussed interactive self-management tools.This abstract has also been published on the funders website (UK Research and Innovation. Improving Mental Health Literacy Among Young People aged 12-15 years in Indonesia 2019).

Recommendations for Measurement of Child Health Literacy: A Pragmatic Approach.

Recommendations for Measurement of Child Health Literacy: A Pragmatic Approach.

O11 Health Literacy of children with Type 1 Diabetes (T1D): a play-based intervention

O11 Health Literacy of children with Type 1 Diabetes (T1D): a play-based intervention

Advancing perspectives on health literacy in childhood and youth.

Children and young people's importance as core target population for health literacy has been highlighted throughout the literature due to the relevance of the early life phases for maintaining, restoring and promoting health during the life course. Transferring health literacy concepts to the target population, however, requires proper testing of their applicability and their fit to the developmental phases as well as the target populations' realities and needs. This article aims to discuss children's and young people's health literacy by elaborating and exploring childhood and youth as life phases with unique characteristics from multidisciplinary perspectives. Drawing on theories and findings from developmental studies, sociology and socialization research, health literacy in childhood and youth is discussed along five 'D' dimensions: (i) disease patterns and health perspectives, (ii) demographic patterns, (iii) developmental change, (iv) dependency and (v) democracy. The unique particularities of children and young people relevant for health literacy include their disease and health-risk profiles, their vulnerability to demographic factors, their social role and status, and their right to participation. Inter- and intra-generational relationships and an unequal distribution of power can either promote or hinder children and young people's health literacy development and their opportunities for participating in health-related decision making. Specifying what is called the 'contextual' and 'relational' dimension of health literacy for the target group requires considering their personal attributes and agency as contextually embedded and interrelated. Taking these considerations into account can help to move towards a more tailored and holistic approach to health literacy of children and young people.