Health-related behaviour, knowledge, attitudes, communication and social status in school children in Eastern Germany.
Enhancing health literacy is a keystone in health promotion. Yet, most studies on health literacy are limited to functional literacy levels. Furthermore, little evidence is available from children. Based on Nutbeam's outcome model for health promotion, this study aims (i) to elaborate a set of short scales to measure important health literacy domains in children and (ii) to analyse their associations among each other, with health behaviour as an intermediate health outcome, subjective health, social status and gender. The sample comprised 852 school children in fifth grade, aged 9-13 years, in Western Pomerania, Germany. Items were taken from the child's questionnaire to form short scales for health-related knowledge, attitudes, communication and behaviour. The internal consistencies of the communication and attitude scales were 0.73 and 0.57, respectively. Unidimensional scalability of the knowledge and behaviour scales was supported by item response models. Associations between health scales were modest. In regression analyses, social status and gender predicted only health knowledge and communication but not health behaviours, attitudes and self-efficacy. Health knowledge was not associated with any other scale. Our results suggest that targeting one specific component of health literacy in children is likely to exert only small effects on health status and health behaviour.
Methods of Community Medicine, Institute of Community Medicine, University of Greifswald, Walther Rathenau Strasse 48, 17487 Greifswald, Germany. carsten.schmidt@uni-greifswald.de
Carsten Oliver
CO
Schmidt
Ruth A
RA
Fahland
Marco
M
Franze
Christian
C
Splieth
Jochen René
JR
Thyrian
Sandra
S
Plachta-Danielzik
Wolfgang
W
Hoffmann
Thomas
T
Kohlmann
D000293:Adolescent; D002648:Child; D003142:Communication; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008297:Male; D020377:Self Efficacy; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors