Central Department of Public Health, Institute of Medicine, Tribhuvan University, Maharajgunj, 44600, Kathmandu, Nepal.
Department of Research and Knowledge Management, Nepal Health Frontiers, Tokha-5, 44600, Kathmandu, Nepal.
Health Promot Int. 2024 Aug 1;39(4). doi: 10.1093/heapro/daae059.
Limited health literacy is linked to unhealthy behaviors, adverse health outcomes, poor quality of life and financial burdens on society. However, little is known about the level of health literacy, especially among school-going children. This cross-sectional study assesses health literacy levels and their determinants in 354 school children from Kathmandu Metropolitan City, utilizing a multi-stage cluster sampling method. The 10-item Health Literacy for School-Aged Children was used to measure the student's literacy levels. Bivariate analysis and multivariable logistic regression at the significance level of 0.05 were performed to determine factors associated with limited health literacy. The majority of participants (76.6%) had moderate health literacy, while 13.8% had a high level and 9.6% had a low level of health literacy. Students from nuclear families had lower odds [adjusted odds ratio (aOR): 0.4; 95% CI: 0.2-0.8] of having limited health literacy. Students whose mother education was up to secondary school (aOR: 10.1; 95% CI: 1.3-78.9), students with pre-existing mental health conditions (aOR: 3.7; 95% CI: 1.4-9.6) and students with unsatisfactory health status (aOR: 3.9; 95% CI: 1.5-10.5) had higher odds to have limited health literacy. These results suggest the importance of prioritizing school health promotion and education activities for students with pre-existing mental health conditions and mothers with low educational attainment. Implementing peer support group programs for children with mental illnesses, mobilizing school health professionals and introducing interventions such as vocational training of mothers can collectively improve health literacy among school-going children.
健康素养有限与不良行为、不良健康结果、生活质量差和社会经济负担有关。然而，人们对健康素养水平，尤其是在校儿童的健康素养水平知之甚少。本横断面研究利用多阶段聚类抽样方法评估了加德满都市 354 名在校儿童的健康素养水平及其决定因素。采用 10 项儿童健康素养量表来衡量学生的读写能力水平。采用双变量分析和多变量逻辑回归（显著性水平为 0.05）来确定与有限健康素养相关的因素。大多数参与者（76.6%）具有中等健康素养，13.8%具有较高水平，9.6%具有较低水平。来自核心家庭的学生有较低的有限健康素养的可能性[调整后的优势比（aOR）：0.4；95%置信区间（CI）：0.2-0.8]。母亲教育程度达到中学（aOR：10.1；95% CI：1.3-78.9）、有先前存在的心理健康状况（aOR：3.7；95% CI：1.4-9.6）和健康状况不满意（aOR：3.9；95% CI：1.5-10.5）的学生有更高的可能性出现有限的健康素养。这些结果表明，优先考虑针对有先前存在的心理健康状况的学生和教育程度较低的母亲开展学校健康促进和教育活动的重要性。为患有精神疾病的儿童实施同伴支持小组计划、动员学校卫生专业人员并引入母亲职业培训等干预措施，可以共同提高在校儿童的健康素养。
