Cross-sectional survey of health literacy among high school students in Armenia

Abstract Background We assessed the level of health literacy (HL) and explored its predictors among 15-17 years old adolescents in Armenia. Methods We conducted a survey among adolescents in public and private schools in the capital Yerevan and an adjacent province in 2023. The instrument included items on HL, general interest in health and socio-demographics. Ten questions measuring HL with four answer options were summed into the HL score (0-30). Multivariable regression model explored the independent associations of socio-demographic factors and interest in health issues with the HL. Results Overall, 366 students completed the survey. About 64% were females. The majority were interested in health issues (80.7%). Most participants felt they, in general, received sufficient health information (75.1%), could follow physician’s instructions (80.1%), were confident in advising family or friends on health improvements (70.5%), could easily give examples of health-promoting actions (76.8%), and explain their choices for health (77.6%). Additionally, 82.2% could judge the environmental impact of their actions, 82.0% could find understandable health information when needed, and 85.3% could assess how their behavior affects their health. Fewer respondents were confident in figuring out if the health information is correct (68.2%) or identifying correct health information when faced with conflicting data (67.1%). The average HL score was 17.41 (SD = 4.47), with a 58.0% percent score. In the regression analysis, being from private school vs. public and being interested in health vs. not were significant predictors of higher HL. Conclusions Despite having moderate HL level, a significant portion of Armenian adolescents lacked confidence in discerning correct health information. Interventions should prioritize enhancing HL, emphasizing critical evaluation skills and providing accessible and reliable health information resources tailored to adolescents, particularly in public schools. Key messages • The health literacy among Armenian adolescents was moderate with many lacking confidence in identifying correct health information and differentiating when faced with conflicting data. • Attending a private school and having an interest in health were significant predictors for higher health literacy, emphasizing the need for targeted health and policy interventions.