Health Literacy in Schools? A Systematic Review of Health-Related Interventions Aimed at Disadvantaged Adolescents

Abstract

Socioeconomically disadvantaged populations are at greater risk of adopting unhealthy behaviours and developing chronic diseases. Adolescence has been identified as a crucial life stage to develop lifelong healthy behaviours, with schools often suggested as the ideal environment to foster healthy habits. Health literacy (HL) provides a possible solution to promote such healthy behaviours. The aim of this study was to review school-based HL-related interventions targeting socioeconomically disadvantaged adolescents and to identify effective intervention strategies for this population. Searches were performed in six databases. Inclusion criteria included age: 12–16; the implementation of a school-based intervention related to HL aimed at socioeconomically disadvantaged populations; an intervention focused on: physical activity (PA), diet, mental health, substance abuse or sleep. Forty-one articles were included, with the majority focusing on PA and diet (n = 13), PA (n = 9) or mental health (n = 7). Few interventions focused solely on substance abuse (n = 2) or sleep (n = 1), and none targeted or assessed HL as an outcome measure. There was huge heterogeneity in study design, outcomes measures and effectiveness reported. Effective intervention strategies were identified that can be used to guide future interventions, including practical learning activities, peer support and approaches targeting the school environment, the parents or that link the intervention to the community.

Comparison of Health Literacy Assessment Tools among Beijing School-Aged Children

“…All these findings suggest that HLAT and HLS may better capture a child’s health literacy than NVS. In response to addressing health literacy inequities [ 18 , 79 , 80 ], intervening on upstream determinants of health is worthwhile through strategies, such as cash transfers to low-income families and improving personal self-efficacy skills in school-aged children.…”

Are Health Literacy and Physical Literacy Independent Concepts? A Gender-Stratified Analysis in Medical School Students from Croatia

“…HL includes the capacity to communicate, assert and enact these decisions” [ 10 ]. Therefore, HL has been accepted as an effective concept for health promotion [ 11 ]. Indeed, in a comprehensive review, it was shown that the individuals with lower HL had poorer global health status, were more likely to express symptoms of depression, and had higher all-cause mortality rates [ 8 ].…”

School-based interventions to improve health literacy of senior high school students: a scoping review protocol

“…23 The third focused on school-based health literacy interventions targeted at adolescents aged 12 to 16 years with socioeconomically disadvantaged backgrounds. 24 The fourth review investigated school-based health literacy programs for children age two to 16 years. 25 The fifth review presented a framework for promoting health literacy in schools and evaluated whether Australian school programs meet the proposed guidelines.…”

“…The second examined controlled studies evaluating the effects of media health literacy, school-based interventions on adolescents’ (aged 10 to 18 years) body image concerns, eating concerns, and thin-internalization attitudes 23 . The third focused on school-based health literacy interventions targeted at adolescents aged 12 to 16 years with socioeconomically disadvantaged backgrounds 24 . The fourth review investigated school-based health literacy programs for children age two to 16 years 25 .…”