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. Materials and 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.