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HOME > J Korean Acad Community Health Nurs > Volume 26(3); 2015 > Article
Original Article
Health Literacy and Health Behavior in Late School-age Children
Byeong-Soon Jang, Dong-Hee Kim
Journal of Korean Academy of Community Health Nursing 2015;26(3):199-208.
DOI: https://doi.org/10.12799/jkachn.2015.26.3.199
Published online: September 30, 2015

College of Nursing, Pusan National University, Yangsan, Korea.

• Received: April 27, 2015   • Revised: August 1, 2015   • Accepted: September 14, 2015

© 2015 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study was conducted to analyze the association between health literacy and health behavior and the effect of health literacy on health behavior in late school-age children.
  • Methods
    Data were obtained from 333 participants who were 5th and 6th-grade students sampled from 8 elementary schools in Busan. Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen) and Newest Vital Sign (NVS) was used for assessing linguistic and functional health literacy, and the health promotion behavior score was measured for health behavior.
  • Results
    The percentage of those with limited linguistic and functional health literacy was high (47.1%, 56.8%). Linguistic health literacy (r=.38, p<.001) and functional health literacy (r=.11, p=.048) had a correlation with health behavior. Health behavior was significantly associated with perceived health status (β=1.94, p<.001), number of times of health education (β=0.18, p<.001), academic achievement (p<.001), home literacy environment (β=0.13, p=.016), perception of changes after health education (p=.011), and linguistic health literacy (β=0.23, p<.001).
  • Conclusion
    The results of this study indicate that children with adequate health literacy are more likely to do health behaviors. Therefore, it is important to develop educational strategies to raise children's health literacy level and consequently to induce them to perform more health behaviors in daily life.
Table 1

Characteristics of the Participants (N=333)

Characteristics Categories n (%) M±SD
Grade 5th 165 (49.5)
6th 168 (50.5)
Gender Male 171 (51.4)
Female 162 (48.6)
Self reported achievement High 21 (6.3)
Middle 174 (52.6)
Low 136 (41.1)
No answer 2 (0.6)
Mother's education level ≤High school 55 (25.7)
College 128 (59.8)
≥Graduate 31 (14.5)
Don't know 119 (35.7)
Home literacy environment (books) <10 67 (20.1) 139.3±244.27
≥10 262 (78.7)
Self reportde health status ≤5 32 (10.1) 8.1±1.73
≥6 284 (89.9)
No answer 7 (2.1)
Diagnosed Disease No 295 (88.6)
Yes 38 (11.4)
 Allergic disease 21 (55.3)
 Other disease 17 (44.7)
Admission No 298 (90.0)
Yes 33 (10.0)
No answer 2 (0.6)
Frequency of health education ≤0.5/wk 96 (28.8) 0.7±0.21
>0.6/wk 237 (71.2)
Total 17.7±7.81
Primary source of learning health School 170 (51.2)
Media, Internet 57 (17.2)
Home 37 (11.1)
Books 32 (9.6)
Other 36 (10.8)
No answer 1 (0.3)
Major health information providers Parents 120 (36.1)
Health teacher 103 (31.0)
Doctors 61 (18.4)
Other 48 (14.5)
No answer 1 (0.3)
Interest in health education No interest 5 (1.6)
Usually 60 (18.8)
Interest 255 (79.7)
No answer 13 (3.9)
Perceived benefit for health education No benefit 3 (0.9)
Usually 37 (11.6)
Beneficial 280 (87.5)
No answer 13 (3.9)
Perceived changes after health education Knowledge 151 (46.3)
Attitude 115 (35.3)
Behavior 26 (8.0)
No change 34 (10.4)
No answer 7 (2.1)
Table 2

Health behavior Score and Health Literacy (N=333)

Variables Linguistic health literacy t (p) Functional health literacy F (p)
Limited
(n=157)
Adequate
(n=176)
Likelihood of limited (n=63) Possibility of limited (n=125) Adequate (n=142)
n (%) n (%) n (%) n (%) n (%)
Health literacy score 21.9±13.51 54.5±7.41 -27.68
(<.001)
0.6±0.50 2.6±0.49 4.9±0.81 1,065.63
(<.001)
Health behavior score 117.6±14.33 126.1±12.18 -5.84
(<.001)
119.9±15.07 121.8±13.68 123.2±13.55 1.30
(.275)
daily life and health 4.3±0.53 4.4±0.51 -4.34
(<.001)
4.2±0.55 4.3±0.54 4.4±0.50 1.55
(.214)
disease prevention and health 4.4±0.60 4.6±0.60 -2.85
(.005)
4.4±0.80 4.6±0.04 4.5±0.54 2.52
(.082)
Drug abuse prevention 4.4±0.60 4.6±0.60 -2.85
(.005)
4.4±0.80 4.6±0.04 4.5±0.54 2.52
(.082)
Gender and health 4.0±0.61 4.3±0.62 -4.29
(<.001)
4.1±0.75 4.2±0.62 4.3±0.55 2.41
(.092)
Mental health 4.3±0.77 4.6±0.69 -4.15
(<.001)
4.2±1.01 4.5±0.66 4.6±0.62 6.43
(.002)
Society and health 4.1±0.94 4.5±0.81 -3.85
(<.001)
4.0±1.06 4.3±0.82 4.4±0.88 2.90
(.057)
Injury prevention and first aid 3.9±0.75 4.2±0.76 -3.04
(<.001)
4.0±0.92 4.1±0.75 4.1±0.70 0.31
(.735)
Table 3

Differences in Health Literacy and Health Behavior Score according to Characteristics (N=333)

Characteristics Categories Linguistic health literacy x2 (p) Functional health literacy x2 (p) Health behavior x2 (p)
Limited Adequate Likelihood of limited Possibility of limited Adequate
n (%) n (%) n (%) n (%) n (%) M±SD
Grade 5 75 (45.5) 90 (54.5) 0.38
(.584)
43 (26.2) 55 (33.5) 66 (40.2) 11.23
(.004)
120.2±14.55 -2.52
(.012)
6 82 (48.8) 86 (51.2) 20 (11.9) 71 (42.3) 77 (45.8) 124.1±13.29
Gender Male 69 (48.9) 102 (53.1) 0.57
(.450)
38 (22.4) 63 (37.1) 69 (40.6) 2.67
(.264)
122.9±14.21 1.00
(.317)
Female 72 (51.1) 90 (46.9) 25 (15.4) 63 (38.9) 74 (45.7) 121.4±13.86
Self reported achievement High 56 (39.7) 80 (42.1) 3.42
(.181)
19 (14.0) 43 (31.6) 74 (54.4) 16.11
(.003)
125.9±12.40 19.83
(<.001)
(a>b>c)
Middle 72 (51.3) 102 (53.7) 40 (23.1) 68 (39.3) 65 (37.6) 120.8±13.68
Low 13 (9.2) 8 (4.2) 4 (19.0) 13 (61.9) 4 (19.0) 107.5±13.71
Mother's educational level (N =214) ≤High school 32 (38.6) 23 (17.6) 12.44
(.002)
8 (14.5) 28 (50.9) 19 (34.5) 5.12
(.275)
117.7±15.43 7.56
(.001)
(a, c<b)
Graduate 39 (47.0) 89 (67.9) 14 (10.9) 54 (42.2) 60 (46.9) 126.0±11.77
≥Postgraduate 12 (14.5) 19 (14.5) 7 (22.6) 11 (35.5) 13 (41.9) 124.9±14.67
Home literacy environment <10 39 (27.9) 28 (14.8) 8.44
(.004)
13 (19.7) 29 (43.9) 24 (36.4) 1.82
(.403)
45.7±16.03 -4.55
(<.001)
≥10 101 (72.1) 161 (85.2) 47 (17.9) 96 (36.6) 119 (45.4) 41.0±20.04
Self reported health status ≤5 15 (46.9) 17 (53.1) 0.00
(.986)
6 (18.8) 10 (31.3) 16 (50.0) 0.75
(.686)
112.9±16.38 -3.96
(<.001)
≥6 135 (47.0) 152 (53.0) 54 (18.9) 110 (38.5) 122 (42.7) 123.1±13.44
Diagnosed disease No 123 (42.1) 169 (57.9) 0.03
(.862)
56 (19.2) 111 (38.1) 124 (42.6) 0.54
(.764)
122.7±14.00 -0.96
(.338)
Yes 17 (43.6) 22 (56.4) 7 (17.9) 13 (33.3) 19 (48.7) 124.0±12.94
Admission No 129 (43.3) 169 (56.7) 2.06
(.152)
54 (18.1) 115 (38.6) 129 (43.3) 1.10
(.577)
121.8±14.06 -1.06
(.292)
Yes 10 (30.3) 230 (69.7) 8 (26.0) 10 (46.9) 9 (28.1) 124.5±12.64
Frequency of health education ≤0.5/wk 45 (46.9) 51 (53.1) 0.00
(.950)
27 (28.4) 32 (33.7) 36 (37.9) 7.72
(.021)
119.6±14.05 -2.05
(.041)
>0.5/wk 112 (47.3) 125 (52.7) 36 (15.2) 94 (39.7) 107 (45.1) 123.1±12.72
Perceived change after health education Attitude 47 (34.1) 68 (36.2) 1.04
(.792)
24 (21.1) 48 (42.1) 42 (36.8) 6.67
(.353)
122.9±14.73 5.14
(.001)
(a, b, c>d)
Knowledge 67 (48.6) 84 (44.7) 28 (18.5) 49 (32.5) 74 (49.0) 122.3±13.63
Behavior 9 (6.5) 17 (9.0) 5 (19.2) 10 (38.5) 11 (42.3) 125.6±8.10
No change 15 (10.9) 19 (10.1) 4 (11.8) 17 (50.0) 13 (38.2) 114.4±14.17

Scheffé test.

Table 4

Correlation among Health Literacy and Health Behavior

Variables Health behavior Linguistic health literacy Functional health literacy
r (p) r (p) r (p)
Health behavior 1
Linguistic health literacy (REALM-TEEN) .38 (<.001) 1
Functional health literacy (NVS) .11 (.048) .01 (.874) 1

REALM-TEEN=rapid estimate of adolescent literacy in medicine; NVS=newest vital sign.

Table 5

Hierarchical Multiple Linear Regression of Health Literacy on Health Behavior

Variables Model 1 Model 2
β t p β t p
Self reported health status 1.94 3.73 <.001 0.21 4.18 <.001
Times of health education 0.18 3.56 <.001 0.15 3.03 .003
Self reported achievement (1=high) 0.56 4.96 <.001 0.46 4.30 <.001
Self reported achievement (1=middle) 0.44 3.94 <.001 0.35 3.27 .001
Perceived changes after HE (1=no change) -0.13 -2.55 .011 -0.15 -3.11 .002
Home literacy environment (books) 0.13 2.42 .016
Linguistic health literacy 0.32 6.55 <.001
F (p) 15.15 (<.001) 23.01 (<.001)
R2 .24 (.235) .32 (.319)
Adjusted R2 .22 (.219) .31 (.305)

β=standarized beta; HE=health education; Dummy variables.

This study was supported by Research Institute of Nursing Science, Pusan National University.

  • 1. Shin MH, Seo EH, Song SG, Kim EK, Won YS, Noh WG, et al. Developmental psychology. Seoul: Hakjisa; 2013. p. 182.
  • 2. Farrand LL, Cox CL. Determinants of positive health behavior in middle childhood. Nurs Res. 1993;42(4):208–213. ArticlePubMed
  • 3. World Health Organization. Report No. 870. Promoting health through schools. Geneva: World Health Organization; 1997. 09.
  • 4. Kim SH, Lee JH. Test of a hypothetical model for health promoting behavior in school-aged children. J Korean Acad Child Health Nurs. 2008;14(1):22–34.
  • 5. Institute of Medicine. Health literacy: A prescription to end confusion. Washington DC: National Academy Press; 2004. p. 41.
  • 6. Nutbeam D. Literacies across the lifespan: Health literacy. Lit Numeracy Stud. 1999;9(2):47–55.
  • 7. von Wagner C, Steptoe A, Wolf MS, Wardle J. Health literacy and health actions: A review and a framework from health psychology. Health Educ Behav. 2009;36(5):860–877. ArticlePubMedPDF
  • 8. Dewalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP. Literacy and health outcomes. J Gen Intern Med. 2004;19(12):1228–1239. ArticlePubMedPMC
  • 9. DeWalt DA, Hink A. Health literacy and child health outcomes: A systematic review of the literature. Pediatrics. 2009;124(3):S265–S274. ArticlePubMedPDF
  • 10. Nutbeam D. Health promotion glossary. Health Promot. 1986;1(1):113–127. ArticlePubMed
  • 11. Davis TC, Crouch MA, Long SW, Jackson RH, Bates P, George RB, et al. Rapid assessment of literacy levels of adult primary care patients. Fam Med. 1991;23(6):433–435. PubMed
  • 12. Lee TW, Kang SJ. Health literacy in the Korean elderly and influencing factors. J Korean Gerontol Soc. 2008;28(4):847–863.
  • 13. Lee SH, Choi EHR, Je MJ. Comparison of two versions of KHLAT for improvement strategies. Korean J Health Educ Promot. 2011;28(3):57–65.
  • 14. Ahn EJ, Kwon IS. Health literacy of elementary school students. Child Health Nurs Res. 2014;20(4):322–331. ArticlePDF
  • 15. Sanders LM, Zacur G, Haecker T, Klass P. Number of children's books in the home: An indicator of parent health literacy. Ambul Pediatr. 2004;4(5):424–428. ArticlePubMed
  • 16. Driessnack M, Chung S, Perkhounkova E, Hein M. Using the "newest vital sign" to assess health literacy in children. J Pediatr Health Care. 2014;28(2):165–171. ArticlePubMed
  • 17. Moore V. Assessing health literacy. J Nurse Pract. 2012;8(3):243–244. Article
  • 18. Davis TC, Wolf MS, Arnold CL, Byrd RS, Long SW, Springer T, et al. Development and validation of the Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen): A tool to screen adolescents for below-grade reading in health care settings. Pediatrics. 2006;118(6):e1707–e1714. ArticlePubMedPDF
  • 19. Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP, et al. Quick assessment of literacy in primary care: The newest vital sign. Ann Fam Med. 2005;3(6):514–522. ArticlePubMedPMC
  • 20. Richard CH. Newest vital sign toolkit [Internet] NY: Pfizer Inc; 2011;cited 2015 January 15. Available from: http://www.pfizer.com/files/health/nvs_flipbook_english_final.pdf
  • 21. Pender NJ, Pender AR. Illness prevention and health promotion services provided by nurse practitioners: Predicting potential consumers. Am J Public Health. 1980;70(8):798–803. ArticlePubMedPMC
  • 22. Walker SN, Sechrist KR, Pender NJ. The health-promoting lifestyle profile: development and psychometric characteristics. Nurs Res. 1987;36(2):76–81. PubMed
  • 23. Kim HS, Kim YI. Factors related to health promoting behavior in late school-age Children. J Korean Soc Sch Health. 2010;23(1):1–10.
  • 24. Nah JY, Kim YI, Kim HS. The effects of systematic health education on health knowledge and health promotion behavior in elementary school students. J Korean Soc Sch Health. 2011;24(2):173–180.
  • 25. Chang LC. Health literacy, self-reported status and health promoting behaviours for adolescents in Taiwan. J Clin Nurs. 2011;20(1/2):190–196. ArticlePubMed
  • 26. Schmidt CO, Fahland RA, Franze M, Splieth C, Thyrian JR, Plachta-Danielzik S, et al. Health-related behaviour, knowledge, attitudes, communication and social status in school children in Eastern Germany. Health Educ Res. 2010;25(4):542–551. ArticlePubMed
  • 27. Brown SL, Teufel JA, Birch DA. Early adolescents perceptions of health and health literacy. J Sch Health. 2007;77(1):7–15. ArticlePubMed
  • 28. Zullig KJ, Ubbes VA, Mann M. Early adolescent literacy influences, reading ability, and preventative health behaviors. Am J Health Stud. 2013;28(3):134–141.
  • 29. Borzekowski DL. Considering children and health literacy: A theoretical approach. Pediatrics. 2009;124(3):S282–S288. ArticlePubMed
  • 30. Joint Committee on National Health Education Standards. Achieving health literacy: An investment in the future. Atlanta, GA: American Cancer Society; 1995. p. 88.

Figure & Data

References

    Citations

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    Health Literacy and Health Behavior in Late School-age Children
    Health Literacy and Health Behavior in Late School-age Children
    Characteristics Categories n (%) M±SD
    Grade 5th 165 (49.5)
    6th 168 (50.5)
    Gender Male 171 (51.4)
    Female 162 (48.6)
    Self reported achievement High 21 (6.3)
    Middle 174 (52.6)
    Low 136 (41.1)
    No answer 2 (0.6)
    Mother's education level ≤High school 55 (25.7)
    College 128 (59.8)
    ≥Graduate 31 (14.5)
    Don't know 119 (35.7)
    Home literacy environment (books) <10 67 (20.1) 139.3±244.27
    ≥10 262 (78.7)
    Self reportde health status ≤5 32 (10.1) 8.1±1.73
    ≥6 284 (89.9)
    No answer 7 (2.1)
    Diagnosed Disease No 295 (88.6)
    Yes 38 (11.4)
     Allergic disease 21 (55.3)
     Other disease 17 (44.7)
    Admission No 298 (90.0)
    Yes 33 (10.0)
    No answer 2 (0.6)
    Frequency of health education ≤0.5/wk 96 (28.8) 0.7±0.21
    >0.6/wk 237 (71.2)
    Total 17.7±7.81
    Primary source of learning health School 170 (51.2)
    Media, Internet 57 (17.2)
    Home 37 (11.1)
    Books 32 (9.6)
    Other 36 (10.8)
    No answer 1 (0.3)
    Major health information providers Parents 120 (36.1)
    Health teacher 103 (31.0)
    Doctors 61 (18.4)
    Other 48 (14.5)
    No answer 1 (0.3)
    Interest in health education No interest 5 (1.6)
    Usually 60 (18.8)
    Interest 255 (79.7)
    No answer 13 (3.9)
    Perceived benefit for health education No benefit 3 (0.9)
    Usually 37 (11.6)
    Beneficial 280 (87.5)
    No answer 13 (3.9)
    Perceived changes after health education Knowledge 151 (46.3)
    Attitude 115 (35.3)
    Behavior 26 (8.0)
    No change 34 (10.4)
    No answer 7 (2.1)
    Variables Linguistic health literacy t (p) Functional health literacy F (p)
    Limited
    (n=157)
    Adequate
    (n=176)
    Likelihood of limited (n=63) Possibility of limited (n=125) Adequate (n=142)
    n (%) n (%) n (%) n (%) n (%)
    Health literacy score 21.9±13.51 54.5±7.41 -27.68
    (<.001)
    0.6±0.50 2.6±0.49 4.9±0.81 1,065.63
    (<.001)
    Health behavior score 117.6±14.33 126.1±12.18 -5.84
    (<.001)
    119.9±15.07 121.8±13.68 123.2±13.55 1.30
    (.275)
    daily life and health 4.3±0.53 4.4±0.51 -4.34
    (<.001)
    4.2±0.55 4.3±0.54 4.4±0.50 1.55
    (.214)
    disease prevention and health 4.4±0.60 4.6±0.60 -2.85
    (.005)
    4.4±0.80 4.6±0.04 4.5±0.54 2.52
    (.082)
    Drug abuse prevention 4.4±0.60 4.6±0.60 -2.85
    (.005)
    4.4±0.80 4.6±0.04 4.5±0.54 2.52
    (.082)
    Gender and health 4.0±0.61 4.3±0.62 -4.29
    (<.001)
    4.1±0.75 4.2±0.62 4.3±0.55 2.41
    (.092)
    Mental health 4.3±0.77 4.6±0.69 -4.15
    (<.001)
    4.2±1.01 4.5±0.66 4.6±0.62 6.43
    (.002)
    Society and health 4.1±0.94 4.5±0.81 -3.85
    (<.001)
    4.0±1.06 4.3±0.82 4.4±0.88 2.90
    (.057)
    Injury prevention and first aid 3.9±0.75 4.2±0.76 -3.04
    (<.001)
    4.0±0.92 4.1±0.75 4.1±0.70 0.31
    (.735)
    Characteristics Categories Linguistic health literacy x2 (p) Functional health literacy x2 (p) Health behavior x2 (p)
    Limited Adequate Likelihood of limited Possibility of limited Adequate
    n (%) n (%) n (%) n (%) n (%) M±SD
    Grade 5 75 (45.5) 90 (54.5) 0.38
    (.584)
    43 (26.2) 55 (33.5) 66 (40.2) 11.23
    (.004)
    120.2±14.55 -2.52
    (.012)
    6 82 (48.8) 86 (51.2) 20 (11.9) 71 (42.3) 77 (45.8) 124.1±13.29
    Gender Male 69 (48.9) 102 (53.1) 0.57
    (.450)
    38 (22.4) 63 (37.1) 69 (40.6) 2.67
    (.264)
    122.9±14.21 1.00
    (.317)
    Female 72 (51.1) 90 (46.9) 25 (15.4) 63 (38.9) 74 (45.7) 121.4±13.86
    Self reported achievement High 56 (39.7) 80 (42.1) 3.42
    (.181)
    19 (14.0) 43 (31.6) 74 (54.4) 16.11
    (.003)
    125.9±12.40 19.83
    (<.001)
    (a>b>c)
    Middle 72 (51.3) 102 (53.7) 40 (23.1) 68 (39.3) 65 (37.6) 120.8±13.68
    Low 13 (9.2) 8 (4.2) 4 (19.0) 13 (61.9) 4 (19.0) 107.5±13.71
    Mother's educational level (N =214) ≤High school 32 (38.6) 23 (17.6) 12.44
    (.002)
    8 (14.5) 28 (50.9) 19 (34.5) 5.12
    (.275)
    117.7±15.43 7.56
    (.001)
    (a, c<b)
    Graduate 39 (47.0) 89 (67.9) 14 (10.9) 54 (42.2) 60 (46.9) 126.0±11.77
    ≥Postgraduate 12 (14.5) 19 (14.5) 7 (22.6) 11 (35.5) 13 (41.9) 124.9±14.67
    Home literacy environment <10 39 (27.9) 28 (14.8) 8.44
    (.004)
    13 (19.7) 29 (43.9) 24 (36.4) 1.82
    (.403)
    45.7±16.03 -4.55
    (<.001)
    ≥10 101 (72.1) 161 (85.2) 47 (17.9) 96 (36.6) 119 (45.4) 41.0±20.04
    Self reported health status ≤5 15 (46.9) 17 (53.1) 0.00
    (.986)
    6 (18.8) 10 (31.3) 16 (50.0) 0.75
    (.686)
    112.9±16.38 -3.96
    (<.001)
    ≥6 135 (47.0) 152 (53.0) 54 (18.9) 110 (38.5) 122 (42.7) 123.1±13.44
    Diagnosed disease No 123 (42.1) 169 (57.9) 0.03
    (.862)
    56 (19.2) 111 (38.1) 124 (42.6) 0.54
    (.764)
    122.7±14.00 -0.96
    (.338)
    Yes 17 (43.6) 22 (56.4) 7 (17.9) 13 (33.3) 19 (48.7) 124.0±12.94
    Admission No 129 (43.3) 169 (56.7) 2.06
    (.152)
    54 (18.1) 115 (38.6) 129 (43.3) 1.10
    (.577)
    121.8±14.06 -1.06
    (.292)
    Yes 10 (30.3) 230 (69.7) 8 (26.0) 10 (46.9) 9 (28.1) 124.5±12.64
    Frequency of health education ≤0.5/wk 45 (46.9) 51 (53.1) 0.00
    (.950)
    27 (28.4) 32 (33.7) 36 (37.9) 7.72
    (.021)
    119.6±14.05 -2.05
    (.041)
    >0.5/wk 112 (47.3) 125 (52.7) 36 (15.2) 94 (39.7) 107 (45.1) 123.1±12.72
    Perceived change after health education Attitude 47 (34.1) 68 (36.2) 1.04
    (.792)
    24 (21.1) 48 (42.1) 42 (36.8) 6.67
    (.353)
    122.9±14.73 5.14
    (.001)
    (a, b, c>d)
    Knowledge 67 (48.6) 84 (44.7) 28 (18.5) 49 (32.5) 74 (49.0) 122.3±13.63
    Behavior 9 (6.5) 17 (9.0) 5 (19.2) 10 (38.5) 11 (42.3) 125.6±8.10
    No change 15 (10.9) 19 (10.1) 4 (11.8) 17 (50.0) 13 (38.2) 114.4±14.17
    Variables Health behavior Linguistic health literacy Functional health literacy
    r (p) r (p) r (p)
    Health behavior 1
    Linguistic health literacy (REALM-TEEN) .38 (<.001) 1
    Functional health literacy (NVS) .11 (.048) .01 (.874) 1
    Variables Model 1 Model 2
    β t p β t p
    Self reported health status 1.94 3.73 <.001 0.21 4.18 <.001
    Times of health education 0.18 3.56 <.001 0.15 3.03 .003
    Self reported achievement (1=high) 0.56 4.96 <.001 0.46 4.30 <.001
    Self reported achievement (1=middle) 0.44 3.94 <.001 0.35 3.27 .001
    Perceived changes after HE (1=no change) -0.13 -2.55 .011 -0.15 -3.11 .002
    Home literacy environment (books) 0.13 2.42 .016
    Linguistic health literacy 0.32 6.55 <.001
    F (p) 15.15 (<.001) 23.01 (<.001)
    R2 .24 (.235) .32 (.319)
    Adjusted R2 .22 (.219) .31 (.305)
    Table 1 Characteristics of the Participants (N=333)

    Table 2 Health behavior Score and Health Literacy (N=333)

    Table 3 Differences in Health Literacy and Health Behavior Score according to Characteristics (N=333)

    Scheffé test.

    Table 4 Correlation among Health Literacy and Health Behavior

    REALM-TEEN=rapid estimate of adolescent literacy in medicine; NVS=newest vital sign.

    Table 5 Hierarchical Multiple Linear Regression of Health Literacy on Health Behavior

    β=standarized beta; HE=health education; Dummy variables.


    RCPHN : Research in Community and Public Health Nursing
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