ADOLESCENTS’ HEALTH LITERACY IN LITHUANIA

Abstract

Objective. Adolescents’ health literacy is an important health promotion factor related to the ability to understand, evaluate, and apply health information. The aim of the study was to assess adolescent health literacy using the Australian Health Literacy Questionnaire (HLQ) taking into account demographic and behavior factors. The study was conducted within the framework of the international project Joint Action on Cardiovascular Diseases and Diabetes (JACARDI), Work Package 6 “Health Literacy and Awareness.”
Methodology.  Health Literacy Questionnaire (HLQ) consisting of 9 scales was translated from English into Lithuanian using a translation integrity procedure involving the double-blind forward and back translation method. Data were collected in secondary schools across eight Lithuanian municipalities during November–December 2024. A total of 1,104 students from grades 9 to 12 completed the questionnaires. The mean scores, standard deviations, and 95% confidence intervals of the scales were calculated. ANOVA was used to assess differences between adolescent groups. Cluster analysis was performed to identify groups of respondents with similar health literacy profiles. The mean scores of each of the nine scales were standardized and converted to Z-scores. Hierarchical classification using Ward’s method was applied, based on the Ophelia (Optimizing Health Literacy and Access) methodology.
Results and conclusions. The study revealed an average level of health literacy among adolescents. The fewest challenges were reported for Scale 5. Social support for health, while the greatest difficulties were observed for Scale 6. Appraisal of health information. Health literacy, indicating fewer health-related challenges, was observed among girls, adolescents without harmful habits, those who are physically active, eat healthily, and consider their body weight to be normal. Cluster analysis identified 13 distinct health literacy profiles, reflecting diverse strengths and needs among adolescents. A total of 13.4% of adolescents assigned to Clusters 1–3 exhibited relatively few health literacy challenges, whereas 15% of those classified within Clusters 11–13 demonstrated pronounced health literacy deficits across all nine scales of the HLQ. Cluster sizes varied considerably, ranging from 236 adolescents in Cluster 4 to 5 adolescents in Cluster 8. These findings reveal considerable heterogeneity in the health literacy profiles of Lithuanian adolescents. Cluster analysis provides a foundation for developing targeted health promotion strategies tailored to specific adolescent groups.