Association of health literacy with quality of life and health outcomes among school-age children in Japan: A cross-sectional study

Health literacy is a modifiable determinant of health with the potential to enhance public health. An association between health literacy and health-related quality of life has been reported. Although each country has developed their own original health literacy scales, the assessment of adolescent health literacy using the Health Literacy Scale for School-Aged Children has not yet been studied in Japan. In this study, we aimed to clarify the factors associated with adolescents' health literacy and examine the relationship between health literacy, health-related behaviors, and health-related quality of life in Japan. Participants were recruited by a research company using registered monitors (1st- to 3rd-year junior high school students and their mothers living in Japan in August 2023). Multivariate regression analysis was performed using the total EuroQoL Five Dimensions, Youth Version scores. SAS software was used for data analysis. Overall, 1,854 adolescents and their mothers participated in the online survey. Factors associated with Health Literacy Scale for School-Aged Children included physical activity, sleep conditions in health-related behaviors, parental communication, parental health literacy, and health-related quality of life. Furthermore, parental health literacy was associated to children's quality of life. Our study showed the influence of family variables, highlighting the need for tailored approaches that consider parents' health literacy levels.