Health literacy among schoolchildren in Republic of Kazakhstan: socio-demographic differences and associations with behavioral risk factors

Improving health literacy in adolescents is an important factor in the development of sustainable behaviors that promote health. However, in the Republic of Kazakhstan, systemic data on such literacy among adolescents and its relationship to behavioral risk factors are scarce, supporting the relevance of this study. Objective. To analyze the literacy in health issues of school-aged children 11—15 years of age in the Republic of Kazakhstan, considering the socio-demographic characteristics, and to determine the relationship with the prevalence of behavioral risk factors for health. Materials and methods. The study was conducted as part of the international Health Behavior in School-aged Children project. The survey involved 8.528 school-aged children from all regions of the Republic of Kazakhstan, selected based on a representative stratified sample. Health literacy was assessed using a validated scale with ten statements, followed by the calculation of the total score in points and the classification of the literacy level into three categories: low, medium, and high. Methods of descriptive statistics, χ², U-Mann—Whitney test, Welch corrected ANOVA, and binary logistic regression were used. Results. There were statistically significant differences in literacy levels by age and place of residence, but not by gender or level of family welfare. A positive association was found between higher literacy levels and healthy behaviors, such as regular physical activity, avoidance of psychoactive substance use, and adherence to a healthy diet. The results of logistic regression and variance analysis confirm the importance of literacy level as a factor associated with adolescents’ self-assessment of health and behavioral style. Conclusion. The results indicate the need to develop and implement targeted health literacy programs as a key tool for disease prevention and fostering sustainable, healthy behaviors in adolescents.