Researcher, (
Assistant Professor, (
J Sch Health. 2021 Aug;91(8):608-616. doi: 10.1111/josh.13051. Epub 2021 Jun 6.
Many studies document associations between low health literacy (HL) and poor health behaviors and outcomes. Yet, HL is understudied among adolescents, particularly from underserved, rural communities. We targeted rural adolescents in this cross-sectional study and explored relationships between HL and (1) energy-balance-related health behaviors and (2) body mass index (BMI) and quality of life (QOL).
Surveys were administered to 7th graders across 8 middle schools in rural Appalachia. HL was assessed using the Newest Vital Sign. Energy-balance-related behaviors and QOL were assessed using validated instruments. Height and weight were objectively measured. Analyses were conducted using the Hodges-Lehmann nonparametric median difference test.
Of the 854 adolescent students (mean age = 12; 55% female), 47% had limited HL. Relative to students with higher HL, students with lower HL reported significantly lower frequency of health-promoting behaviors (water, fruit and vegetable intake, physical activity, sleep), higher frequency of risky health behaviors (sugar-sweetened beverages, junk food, screen time), and had higher BMI percentiles and lower QOL (all p < .05).
Low HL is associated with energy-balance-related behaviors, BMI, and QOL among rural, Appalachian adolescents. Findings underscore the relevance of HL among rural middle school students and highlight implications for school health.
许多研究记录了低健康素养（HL）与不良健康行为和结果之间的关联。然而，在青少年中，尤其是在服务不足的农村社区中，HL 的研究还很不足。在这项横断面研究中，我们将目标锁定在农村青少年身上，探讨了 HL 与（1）与能量平衡相关的健康行为和（2）体重指数（BMI）和生活质量（QOL）之间的关系。
在阿巴拉契亚农村的 8 所中学对 7 年级学生进行了调查。使用最新生命体征评估 HL。使用经过验证的工具评估与能量平衡相关的行为和 QOL。身高和体重通过客观测量。使用 Hodges-Lehmann 非参数中位数差异检验进行分析。
在 854 名青少年学生中（平均年龄 12 岁，55%为女性），有 47%的学生 HL 有限。与 HL 较高的学生相比，HL 较低的学生报告健康促进行为（水、水果和蔬菜摄入、体力活动、睡眠）的频率显著较低，风险健康行为（含糖饮料、垃圾食品、屏幕时间）的频率更高，BMI 百分位数更高，生活质量更低（均 p < 0.05）。
在农村阿巴拉契亚青少年中，HL 与与能量平衡相关的行为、BMI 和 QOL 相关。研究结果强调了农村中学生 HL 的相关性，并突出了对学校健康的影响。
