Systematic Review of Health Literacy and Health Promotion in School-Aged Adolescents

Background: The literature has identified gaps in adolescent health literacy (AHL) measurements, as well as how the health literacy (HL) level is related to health promotion (HP) aspects. This study aimed to examine the tools used to measure HL and determine its relation with HP among adolescents. Methods: Three online databases (HINARI, PubMed, and DOAJ) were searched to conduct a systematic assessment of papers published between January 1, 2016, and January 1, 2021. In this review, 373 articles were identified from these databases. After removing duplicates and screening titles and abstracts of articles, 49 full texts were selected for full-text reading. After comprehensive reading, 23 papers were appraised for qualitative synthesis. Results: Of the 23 reviewed papers, 21 focused on assessing AHL measures, and 15 addressed the association between AHL and HP. Seven studies used the HL School-Aged Children instrument. The findings suggested that the methodological and conceptual underpinnings of HL measures are insufficient. Furthermore, HL acts as an independent and positive mediator for many facets of HP. Conclusion: This review offers a warning to practitioners and educationists interested in measuring HL as the number of measurement tools is quite huge with different tools applying different scales.