Health literacy of children and adolescents: Conceptual approaches and developmental considerations

The interest in children and adolescents’ health literacy has strongly increased in recent years (Ormshaw et al, 2013; Bröder et al, 2017). Childhood and adolescence are life phases in which major physical, cognitive and emotional development processes take place. Likewise, health-promoting attitudes, beliefs and behaviours surface in these life phases, and can be supported by meeting children and adolescents’ information needs and fostering their active involvement in their own health. Therefore, addressing health literacy from an early age onwards is argued to be a promising investment in children’s health and wellbeing now and throughout their adolescence and adult lives (Borzekowski, 2009; Sanders et al, 2009; Velardo and Drummond, 2016).The health literacy concept is multifaceted, with diverse conceptual understandings. Sørensen and colleagues (2012, p 3) define health literacy as ‘being linked to literacy and entail[ing] people’s knowledge, motivation and competences to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention, and health promotion to maintain or improve quality of life during the life course.’As for adults, there are various health literacy conceptualisations and definitions addressed to children and adolescents, prominently addressed as outcomes of school health education (Joint Committee on National Health Education Standards, 1995; Paakkari and Paakkari, 2012) or through the focus on their parents or care takers’ health literacy (DeWalt and Hink, 2009; Connelly and Turner, 2017). Moreover, there is limited evidence available regarding their fit and appropriateness for the target group, given their life phase-specific particularities and needs (Bröder et al, 2017). Indeed, Fairbrother and colleagues (2016) have revealed gaps in understanding not only ‘what’ health literacy (skills) children and adolescents have and develop in the different life phases, but also ‘how’ they actually interact with health-related information in their everyday lives. Similarly, Velardo and Drummond (2016) stress the need to bring forward a child-centred health literacy understanding that integrates children’s understanding, attitudes and choices related to health and health-related information.The purpose of this chapter is, therefore, to highlight life phase particularities for health literacy by exploring children and adolescents’ health literacy from development-focused perspectives.Portuguese national funds through the FCT (Foundation for Science and Technology) within the framework of the CIEC (Research Center for Child Studies of the University of Minho) project under the reference UID/CED/00317/2019