Introduction

Adolescence implies specific issues in terms of health literacy. Adolescents have to handle various developmental tasks and increasingly take responsibility for their own health. For developing effective interventions to promote health literacy in adolescence, a robust knowledge of the current level of health literacy in this particular age group is required and still missing in many countries. Filling this research gap, the aims of the study were (1.) to develop a measurement instrument specifically for generic health literacy of adolescents aged 14 to 17 years, and (2.) to assess whether there were differences in the dimensions of generic health literacy among adolescents.

Methods

The self-report measurement tool “Measurement of Health Literacy Among Adolescents”-Questionnaire (MOHLAA-Q) was developed and validated for the use among adolescents aged 14-17 years. It consists of four scales representing cognitive, affective, behavioral, and communicative dimensions of generic health literacy. The MOHLAA-Q was used in a representative nationwide cross-sectional online survey among adolescents aged 14 to 17 years (n=1,235) in Germany. The entire questionnaire of the survey includes socio-demographic variables as well as variables on self-efficacy, social support, and health behavior. Bivariate and multiple logistic regression analyses were carried out.

Results

Relevant differences regarding the four scales of generic health literacy among adolescents were found. The highest proportion of adolescents with poor health literacy levels showed the scales “health-related communication skills” (28.13%) and “health-related knowledge” (22.73%). For the scales “dealing with health-related information” (8.41%) and “attitudes toward one’s own health and health information” (8.81%) these proportions were clearly lower. Significant associations between each of the four scales and different factors such as gender, education, social support, physical activity and nutrition were found, but only self-efficacy was significant for all scales.

Discussion

The MOHLAA-Q allows to identify differences in the cognitive, affective, behavioral, and communicative dimensions of health literacy of adolescents and, indicates that the different dimensions should be addressed in measuring and improving health literacy in adolescence. The results support using different scales in a health literacy measurement instrument in order to reflect the multidimensionality of health literacy.