Peer-reviewed article
Adolescents' health literacy and health-related quality of life: The mediating role of self-efficacy.
Kristin Sofie Waldum-Grevbo, Solveig Holen, Tore Wentzel-Larsen, Åse Sagatun ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines how health literacy affects the quality of life of 13-year-old adolescents in Norway, and whether self-efficacy plays a role in this relationship. Researchers collected data from over 1,400 students across 48 schools and found that higher health literacy was associated with better health-related quality of life. Self-efficacy appeared to mediate between 30% and 76% of this association, depending on which aspect of quality of life was measured.
Key points
- A 10 percentage-point increase in health literacy was associated with increases of 2.47 T-score points in girls and 1.86 points in boys on health-related quality of life measures
- The largest effects of health literacy on quality of life were observed for the School Environment domain
- General self-efficacy mediated 30% to 76% of the association between health literacy and health-related quality of life across different subscales
- Effects were stronger for girls than for boys
- The study used cross-sectional design, which cannot establish causation or temporal ordering
Limitations
This is a cross-sectional study, so it cannot determine whether health literacy causes improved quality of life or whether the relationship is bidirectional. The study cannot establish the temporal sequence of health literacy, self-efficacy, and quality of life.
Abstract
OBJECTIVES: Enhancing Health-related quality of life (HRQoL) among adolescents is a major public health goal. HRQoL is associated with the modifiable factors health literacy and self-efficacy. Theory and research suggest that individuals with higher health literacy are more capable of managing health experiences, which may strengthen self-efficacy and improve HRQoL. However, the mediating role of self-efficacy in the association between health literacy and HRQoL is scarcely studied. The overall aim of this study is to examine the relationship between self-reported health literacy and HRQoL, and the potential mediating role of self-efficacy in 13-year-old boys and girls. STUDY DESIGN: The study employed a cross-sectional, school-based design. METHODS: Self-report data were collected from 1425 13-year-old students (71% response rate) across 48 schools in 19 municipalities across Norway. HRQoL, health literacy, and self-efficacy were assessed using KIDSCREEN-27, HLSAC, and GSE-5, respectively. Mediation analysis was conducted within a causal mediation framework to estimate the potential total, direct, and indirect effects on HRQoL associated with a hypothetical 10-percentage-point increase in the health literacy score, with general self-efficacy as the proposed mediator. RESULTS: Overall, higher health literacy showed a significant increase in HRQoL across all subscales.The largest total effects were observed for the School Environment domain. A hypothetical 10 percentage-point increase in health literacy was associated with increases of 2.47 T-score points (95% CI 2.08-2.85) among girls and 1.86 (95% CI 1.40-2.35) among boys. The proportion potentially mediated through self-efficacy ranged from 30% to 76% across HRQoL subscales. CONCLUSIONS: This study contributes to the literature by suggesting that general self-efficacy may be a potential mediator of the association between health literacy and HRQoL. Future interventions targeting health literacy should be evaluated using longitudinal designs that can assess the temporal ordering from health literacy to general self-efficacy and subsequently to HRQoL.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Improving health literacy (as assessed through cross-sectional association)
- Population
- 13-year-old boys and girls in Norway (1,425 students across 48 schools in 19 municipalities)
Key finding
10 percentage-point increase in health literacy associated with 2.47 T-score point increase in girls' health-related quality of life (95% CI 2.08-2.85)