Health literacy of Iranian adolescent girls and its determinants
More details
Hide details
Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
Zahra Bostani Khalesi   

Nursing and Midwifery School of Shahid Dr. Beheshti, Hamidyan Shahrak, Shahid Dr. Beheshti Ave., Rasht, Guilan, Iran. Tel. +98 33555058.
Submission date: 2020-11-22
Final revision date: 2020-12-31
Acceptance date: 2020-12-31
Online publication date: 2021-06-08
Adolescent health literacy refers to social and cognitive skills that show the motivation and ability of adolescents to receive and use beneficial knowledge to maintain and promote their health status.

Determine the health literacy of Iranian adolescent girls and its determinants.

Material and methods:
This is a cross-sectional-analytical study performed on 324 first- and second-grade high school female students. The sampling method included a multi-stage cluster sampling. Data collection tools included a demographic questionnaire and the health literacy measure for adolescents (HELMA). HELMA consisted of 44 items within 8 areas: self-efficacy, access, reading, understanding, appraisal, use, communication, and numeracy. HELMA was scored based on a 5-point Likert scale.

Results and discussion:
The mean health literacy score of participants was 20.79%. Also, multiple linear regression showed a statistically significant relationship between access area of health literacy with living with one of the parents (P = 0.02), appraisal area with educational level (P = 0.04) and mother’s job (P = 0.03), use the area with mother’s job (P = 0.038), and numeracy area with the who is asked first regarding health or disease-related question (P = 0.004), and understanding the area with parental education (P < 0.01). Overall, the educational level was the most important determinant of health literacy (P = 0.045).

The results of the present study showed that adolescent girls had lower health literacy level. Therefore, it is suggested that health service providers improve the level of adolescent health literacy level by designing and implementing the relevant programs.

None declared.
The authors declared no potential conflicts of interest.
Dick B, Ferguson BJ. Health for the world’s adolescents: A second chance in the second decade. J Adolesc Health. 2015;56(1):3–6.
World Health Organization. Health for the world’s adolescents: A second chance in the second decade: Summary. Geneva: WHO; 2014. Accessed: 01.06.2021.
Zarinkolah A, Dashti F, Abedi H, Masoudi M. A study of puberty health literacy level of the first 14–16 year girls gade high school students in the Eghlid City. J Health Lit. 2016;1(3):164–171 [in Persian].
Binkiewicz-Glińska A, Bakuła S, Kusiak-Kaczmarek M, et al. Obesity prevention in children and adolescents – Current recommendations. Pol Ann Med. 2012;19(2):158–162.
Mokdad AH, Forouzanfar MH, Daoud F. Global burden of diseases, injuries, and risk factors for young people’s health during 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2016;387(10036):2383–2401.
UNICEF. Adolescents overview. 2019. Accessed: 01.06.2021.
Statistical Center of Iran. Results of the 2017 National Population and Housing Census. Accessed:25.08.2017 [in Persian].
SaeedyGolluche F, Jalili Z, Tavakoli R, Ghanbari S. The study of relationship between health literacy and nutritional practice in high school adolescents in Tehran. Iran J Health Educ Health Promot. 2017;5(3):224–230.
Rowlands G. Health literacy. Hum Vaccin Immunother. 2014;10(7):2130–2135.
Manganello JA, DeVellis RF, Davis TC, Schottler-Thal C. Development of the health literacy assessment scale for adolescents (HAS-A). J Commun Healthc. 2015;8(3):172–18.
Hickey KT, Masterson Creber RM, Reading M, et al. Low health literacy: Implications for managing cardiac patients in practice. Nurse Pract. 2018;43(8):49–55.
Bundy DAP, de Silva N, Horton S, Patton GC, Schultz L, Jamison DT. Investment in child and adolescent health and development: Key messages from Disease Control Priorities, 3rd Edition. Lancet. 2018;391(10121): 687–699.
Patton GC, Sawyer SM, Santelli JS. Our future: A Lancet commission on adolescent health and well being. Lancet. 2016;387(10036):2423–2478.
Lomazzi M, Borisch B, Laaser U. The Millennium Development Goals: experiences, achievements and what’s next. Glob Health Action. 2014;7.
UNFPA. International Conference on Population and Development. International Conference on Population and Development: Program of Action. New York, NY: UNFPA; 1994.
Barton AJ, Allen PE, Boyle DK, Loan LA, Stichler JF, Parnell TA. Health literacy: Essential for a culture of health. J Contin Educ Nurs. 2018;49(2):73–78.
Ghanbari S, Ramezankhani A, Montazeri A, Mehrabi Y. Health literacy measure for adolescents (HELMA): Development and psychometric evaluation. J Iran Inst Heal Sci Res. 2016;15(4):388–402.
Kahtari M, Farmanbar R, Kasmaei P, Omidi S. The effect of the educational intervention on health literacy level in the girl students. J Health Lit. 2017;2(3):187–197.
Ahmadi FZ, MehrMohamadi M, Talaee E, et al. Health literacy among students of Farhangian University. Payesh. 2018;17(3):257–266 [in Persian].
Shahhosseini Z, Simbar M, Ramezankhani A. Study of religious needs in adolescent girls in the way of spiritual health in Sari City. Relig Health. 2013;1(1):65–71 [in Persian].
York EA, Dutton M. Religious beliefs and wealth accumulation. JBER. 2012;10(7):407–418.
Karimi S, Keyvanara M, Hosseini M, Jafarian Jazi M, Khorasani E. Health literacy, health status, health services utilization and their relationships in adults in Isfahan. Health Inf Manage. 2014;10(6):862–875.
Kamalipour M, Ashkani N, Mehralizade A, Choubin N, Zadeh ZE. Evaluatiion of adults health literacy in Jahrom. J Prevent Med. 2019;6(1):19–25 [in Persian].
Panahi R, Ramezankhani A, Tavousi M, Osmani F, Niknami S. The relationship between low health literacy and knowledge and attitude towards the harms of smoking in dormitory students. J Health Literacy. 2017;2(3):131–140. [in Persian].