Sukys Saulius, Kuzmarskiene Gerda, Motiejunaite Kristina
Department of Physical and Social Education, Lithuanian Sports University, Sporto g. 6, LT-44221 Kaunas, Lithuania.
Healthcare (Basel). 2024 Dec 22;12(24):2585. doi: 10.3390/healthcare12242585.
Health literacy (HL) is an important element of public health that is linked to health behavior in children and adolescents. This study aimed to investigate the structural validity and reliability of the HLS-Q12 in the adolescent population, to measure the general HL of adolescents, and to assess the relationship between adolescents' HL and health behavior.
This cross-sectional study involved 825 students aged 15-19 years attending Lithuanian gymnasiums. The participants completed an online survey that collected information on key sociodemographic, HL, and health behavior indicators. Factor analysis, Cronbach's alpha, and McDonald's omega were used to validate the Lithuanian version of the HLS-Q12. Health behavior indicators, including physical activity, smoking, alcohol consumption, self-rated health, and body mass index (BMI), were measured. We used regression analyses to assess the associations.
The HLS-Q12 showed an acceptable reliability index (Cronbach's α = 0.885, McDonald's omega ω = 0.877) and adequate structural validity (comparative fit index = 0.89, Tucker and Lewis's index of fit = 0.88, root mean square error of approximation = 0.06). We found that 67.1% of the adolescents had excellent or sufficient HL, 27.7% had problematic HL, and 5.2% had inadequate HL. Compared with girls, boys had greater HL. HL was positively related to physical activity and self-rated health and negatively related to alcohol use and smoking.
HLS-Q12 is a reliable and valid measure of HL among adolescents in upper grades; higher levels of HL have been found to result in better health behaviors.
健康素养（HL）是公共卫生的一个重要要素，与儿童和青少年的健康行为相关。本研究旨在调查青少年群体中HLS-Q12的结构效度和信度，测量青少年的总体健康素养，并评估青少年健康素养与健康行为之间的关系。
这项横断面研究涉及825名年龄在15至19岁的立陶宛文理中学学生。参与者完成了一项在线调查，收集了关键的社会人口统计学、健康素养和健康行为指标信息。采用因子分析、克朗巴哈系数和麦克唐纳欧米伽系数来验证立陶宛语版的HLS-Q12。测量了包括身体活动、吸烟、饮酒、自评健康和体重指数（BMI）在内的健康行为指标。我们使用回归分析来评估关联。
HLS-Q12显示出可接受的信度指数（克朗巴哈系数α = 0.885，麦克唐纳欧米伽系数ω = 0.877）和足够的结构效度（比较拟合指数 = 0.89，塔克和刘易斯拟合指数 = 0.88，近似均方根误差 = 0.06）。我们发现67.1%的青少年具有优秀或足够的健康素养，27.7%的青少年健康素养存在问题，5.2%的青少年健康素养不足。与女孩相比，男孩的健康素养更高。健康素养与身体活动和自评健康呈正相关，与饮酒和吸烟呈负相关。
HLS-Q12是高年级青少年健康素养的可靠且有效的测量工具；已发现较高水平的健康素养会导致更好的健康行为。
