Adolescents' Health Literacy is Directly Associated with Their Physical Activity but Indirectly with Their Body Composition and Cardiorespiratory Fitness: Mediation Analysis of the Slovak HBSC Study Data

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2024 Oct 10

PMID 39390406

Authors

Lenka Hnidkova

Peter Bakalar

Rastislav Magda

Peter Kolarcik

Jaroslava Kopcakova

Zuzana Boberova

Affiliations

Soon will be listed here.

Abstract

Background: Health literacy is a core public health issue in relation to children and adolescents associated with multiple health behaviours and health outcomes. The aim of the study is to test the direct associations between health literacy, physical activity behaviour, health outcomes of body composition and cardiorespiratory fitness among Slovak adolescents and possible indirect effect of health literacy on health outcomes of body composition and cardiorespiratory fitness mediated by adolescents' physical activity behaviour.

Methods: Data from the Slovak Health Behaviour in School-aged Children (HBSC) study conducted in 2022 were used. For the purposes of this study, a subsample of the adolescents (n = 508; mean age = 14.50; SD = 0.82; 54.3% boys) which provided HBSC questionnaire data on health literacy, moderate-to-vigorous physical activity and vigorous physical activity and participated in body composition (InBody 230) and cardiorespiratory fitness (20-m shuttle run test) measurements. Data were analysed using linear regression analysis.

Results: The findings showed that higher health literacy of the adolescents was directly associated with higher frequency of physical activity represented by moderate-to-vigorous physical activity and vigorous physical activity and only with the visceral fat area in the crude model. Furthermore, there was an indirect effect of health literacy on cardiorespiratory fitness and most of the body composition variables (except the Body Mass Index) which was mediated by physical activity of the respondents.

Conclusions: Health literacy is indirectly associated to body composition and cardiorespiratory fitness through higher frequency of physical activity. It seems that health literacy as cognitive and social competencies need behavioural components to be involved in the proposed causal pathway between health literacy and health outcomes. Our findings may contribute to the process of creating a framework for future health literacy interventions in adolescents.

References

Wells J, Chomtho S, Fewtrell M . Programming of body composition by early growth and nutrition. Proc Nutr Soc. 2007; 66(3):423-34. DOI: 10.1017/S0029665107005691. View

Javed A, Jumean M, Murad M, Okorodudu D, Kumar S, Somers V . Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis. Pediatr Obes. 2014; 10(3):234-44. DOI: 10.1111/ijpo.242. View

Rauner A, Mess F, Woll A . The relationship between physical activity, physical fitness and overweight in adolescents: a systematic review of studies published in or after 2000. BMC Pediatr. 2013; 13:19. PMC: 3571910. DOI: 10.1186/1471-2431-13-19. View

Chin S, Kahathuduwa C, Binks M . Physical activity and obesity: what we know and what we need to know. Obes Rev. 2016; 17(12):1226-1244. DOI: 10.1111/obr.12460. View

Lassetter J, Clark L, Morgan S, Brown L, VanServellen G, Duncan K . Health literacy and obesity among native Hawaiian and Pacific Islanders in the United States. Public Health Nurs. 2014; 32(1):15-23. DOI: 10.1111/phn.12155. View

Buja A, Rabensteiner A, Sperotto M, Grotto G, Bertoncello C, Cocchio S . Health Literacy and Physical Activity: A Systematic Review. J Phys Act Health. 2020; 17(12):1259-1274. DOI: 10.1123/jpah.2020-0161. View

Paakkari L, Torppa M, Mazur J, Boberova Z, Sudeck G, Kalman M . A Comparative Study on Adolescents' Health Literacy in Europe: Findings from the HBSC Study. Int J Environ Res Public Health. 2020; 17(10). PMC: 7277198. DOI: 10.3390/ijerph17103543. View

Chaput J, Janssen I, Sampasa-Kanyinga H, Tomkinson G, Lang J . Economic burden of low cardiorespiratory fitness in Canada. Prev Med. 2023; 168:107424. DOI: 10.1016/j.ypmed.2023.107424. View

Kolb S, Burchartz A, Oriwol D, Schmidt S, Woll A, Niessner C . Indicators to Assess Physical Health of Children and Adolescents in Activity Research-A Scoping Review. Int J Environ Res Public Health. 2021; 18(20). PMC: 8535832. DOI: 10.3390/ijerph182010711. View

10.

Kanellopoulou A, Notara V, Antonogeorgos G, Chrissini M, Rojas-Gil A, Kornilaki E . Inverse Association Between Health Literacy and Obesity Among Children in Greece: A School-Based, Cross-Sectional Epidemiological Study. Health Educ Behav. 2021; 49(1):54-65. DOI: 10.1177/1090198120982944. View

11.

Paakkari L, Kokko S, Villberg J, Paakkari O, Tynjala J . Health literacy and participation in sports club activities among adolescents. Scand J Public Health. 2017; 45(8):854-860. DOI: 10.1177/1403494817714189. View

12.

Shah L, West P, Bremmeyr K, Savoy-Moore R . Health literacy instrument in family medicine: the "newest vital sign" ease of use and correlates. J Am Board Fam Med. 2010; 23(2):195-203. DOI: 10.3122/jabfm.2010.02.070278. View

13.

Smith C, Goss H, Issartel J, Belton S . Health Literacy in Schools? A Systematic Review of Health-Related Interventions Aimed at Disadvantaged Adolescents. Children (Basel). 2021; 8(3). PMC: 7996245. DOI: 10.3390/children8030176. View

14.

Lang J, Tomkinson G, Janssen I, Ruiz J, Ortega F, Leger L . Making a Case for Cardiorespiratory Fitness Surveillance Among Children and Youth. Exerc Sport Sci Rev. 2018; 46(2):66-75. DOI: 10.1249/JES.0000000000000138. View

15.

Chang L . Health literacy, self-reported status and health promoting behaviours for adolescents in Taiwan. J Clin Nurs. 2010; 20(1-2):190-6. DOI: 10.1111/j.1365-2702.2009.03181.x. View

16.

. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995; 854:1-452. View

17.

Wells J, Fewtrell M . Measuring body composition. Arch Dis Child. 2006; 91(7):612-7. PMC: 2082845. DOI: 10.1136/adc.2005.085522. View

18.

Siervogel R, Demerath E, Schubert C, Remsberg K, Chumlea W, Sun S . Puberty and body composition. Horm Res. 2003; 60(Suppl 1):36-45. DOI: 10.1159/000071224. View

19.

Sansom-Daly U, Lin M, Robertson E, Wakefield C, McGill B, Girgis A . Health Literacy in Adolescents and Young Adults: An Updated Review. J Adolesc Young Adult Oncol. 2016; 5(2):106-18. DOI: 10.1089/jayao.2015.0059. View

20.

Simmonds M, Burch J, Llewellyn A, Griffiths C, Yang H, Owen C . The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis. Health Technol Assess. 2015; 19(43):1-336. PMC: 4781104. DOI: 10.3310/hta19430. View