Status and determinants of health literacy among adolescents in Guangdong, China.
BACKGROUND
Previous studies for non-communicable disease cotrol, including cancer, have mostly relied on health literacy in adults. However, limited studies are available for adolescents. This study aimed to assess the status and determinants of health literacy in in-school adolescents in Guangdong, China.


METHODS
A total of 3,821 students aged 13-25 years were selected by multi-stage cluster sampling. After the questionnaire of health literacy was answered, the total scores for health knowledge (18 questions), skills (5 questions) and behaviors (14 questions) were determined. The total scores for health literacy and each subscale were recoded into adequate and inadequate subgroups, and logistic regression models were used to identify factors associated with each outcome variable.


RESULTS
The prevalence of adequate health literacy was 14.4%, and the prevalences for adequate knowledge, skills and behavior were 22.4%, 64.7% and 6.6%, respectively. Students coming from prestigious schools and having parents with higher education had higher odds of having adequate knowledge, skills and behaviors. Female students had higher odds of having adequate knowledge and behaviors. Students in grade 7-8 had higher odds of having adequate knowledge and skills. The health knowledge was positive associated with health skills (odds ratio [OR]=2.1, 95% confidence interval [CI] 1.7-2.5) and behaviors (OR=3.0, 95% CI 2.3-4.0), and health skills were positive associated with health behaviors (OR=2.6, 95% CI 1.8-3.8).


CONCLUSIONS
Further efforts should be made to increase adolescents' health knowledge and behaviors, especially for low grade and male students in non-prestigious schools.
Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China E-mail : yaoxuya@163.com, or chensidong1@126.com.
Xiao-Hua
XH
Ye
Yi
Y
Yang
Yan-Hui
YH
Gao
Si-Dong
SD
Chen
Ya
Y
Xu
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002681:China; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D057220:Health Literacy / Q000592:standards* / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D055815:Young Adult