The Concept of Health Literacy in Promoting and Maintaining Adolescent Health - Essay Example

? The Concept of Health Literacy in Promoting and Maintaining Adolescent Health Health literacy is one of the foundational health care constructs. Much has been written and said about the association between health literacy and health outcomes. More often than not, health literacy researchers focus on the analysis of adult literacy. The goal of this paper is to reconsider the concept of health literacy in promoting and maintaining adolescent health. A definition of adolescent health literacy is provided. Factors affecting the concept of health literacy in adolescents are discussed. Recommendations to develop and enhance adolescent health literacy are included. Keywords: health literacy, adolescent, health promotion. The Concept of Health Literacy in Promoting and Maintaining Adolescent Health A young diabetic man, aged 14, learns about a new clinical trial on a new diabetic medicine. He goes to the study site to learn more about the trial. The adolescent is asked to sign an informed consent form; he must also have this form signed by his parents. However, once his mother sees the informed consent form, she realizes that her son’s participation in the trial will put him at high risks of health complications, since his current medicines and health state are in conflict with what is required for and being tested during the trial. This is a routine situation that exposes the role of health literacy for promoting and maintaining adolescent health. Adolescents must be able to read and understand health information. They should be able to use this information in ways that empower them to take proper health decisions. It goes without saying, that the adolescent health literacy is affected and mediated by a multitude of internal and external factors. In this sense, the concept of health literacy in adolescents can be defined as the degree to which young people are capable of accessing, reading, processing, and comprehending health information and use this information to take proper health decisions, promote and maintain their health, based on continuous interactions with their social and cultural environments. Literacy and Health Literacy among Australians Health promotion has long been one of the primary goals of health care; yet, it was not before the 1990s that the importance of health literacy was officially recognized. In the early 1990s health literacy was included in Australia’s health targets and goals (Keleher & Hagger, 2007). These goals and targets include improving language skills, population literacy, and public knowledge of health and health literacy, to ensure that individuals have the information and knowledge required to take informed health decisions (Keleher & Hagger, 2007; Borzekowski & Rickert, 2001). Unfortunately, less than one-fifth of Australians have high levels of literacy, which impedes the development and implementation of health promotion policies (Keleher & Hagger, 2007). Only every third Australian possesses functional literacy to cope with their everyday tasks (Jorm et al., 2006). Thus, just about one half of all Australians have the skills and potential to affect health decisions and promote their own health. This raises the question of bringing up health literacy from a young age. Why care about health literacy among adolescents? The answer is simple: there is no health without health literacy. Limited health literacy is associated with increased utilization of health care services (Keleher & Hagger, 2007). Poor health outcomes are direct results of low health literacy (Farrer et al., 2008; Keleher & Hagger, 2007). Low health literacy predicts poor verbal communication with health care providers and poor medication compliance (Keleher & Hagger, 2007). Therefore, it is imperative that adolescents have the level of health literacy needed to promote and maintain their health. Undoubtedly, superior health literacy is one of the foundational elements of improved health in adolescents and adulthood. The long-term effects of literacy on health cannot be overestimated, but before adolescents can improve their health literacy, its concept and factors affecting adolescent health should be reconsidered. The Concept of Health Literacy in Promoting and Maintaining Adolescent Health The concept of health literacy remains one of the most popular objects of contemporary health research. Much has been written and said about the importance and implications of health literacy for health promotion and improvement among all population groups (Nutbeam, 1998). Nonetheless, the concept of health literacy in the context of adolescent health promotion is persistently disregarded. It is essential for health professionals to have a clear understanding of health literacy, when applied to adolescent health. The current state of literature distinguishes health literacy from health promotion and health education, although literacy is often believed to be the product of these two categories (Higgins, Begoray & MacDonald, 2009). According to the Joint Committee on Health Education Terminology, health literacy is “the continuum of learning, which enables people, as individuals, and as members of social structures, to voluntary make decisions, modify behaviors and change social conditions in ways that are health enhancing” (Higgins et al., 2009, p.351). This definition re-establishes a direct causal link between health literacy and health promotion: in adults and adolescents, health literacy creates the foundation for continuous health improvements, through the relevant decisions which individuals take, based on their knowledge of health and ability to process available health information. Previous researchers demonstrated that health literacy, more than other individual and demographic characteristics, predicted adolescent and adult health status (Fisher-Wilson, 2003; Speros, 2005). Manganello (2008) found that health-literate students had better chances to become healthy adults. Yet, the concept of health literacy among adolescents is somewhat different from that among adults. The concept of health literacy is equally important for adolescent and adult health promotion and maintenance. Yet, adolescents are more susceptible to environmental influences than adults and ground their decisions on how they understand the reality in which they live (Steinberg, 2005). Social interactions play a vital role in how adolescents build and use their health perceptions, and the concept of health literacy in adolescent health is integrally linked to environmental influences. It would be fair to say that the concept of health literacy in adolescent health promotion expands beyond the basic reading and writing skills, applies in the given social and cultural context and exemplifies a complex societal (not individual) characteristic, which has a personal value and operates as a civic obligation (Higgins et al., 2009; Pignone et al., 2005; Smith, 2004). Health literacy should not be limited to managing health conditions and illnesses but should always imply the multitude of health-related decisions adolescents take in everyday life (Nutbeam & Kikbusch, 2000; Peerson & Saunders, 2009). In this sense, the concept of health literacy in promoting and maintaining adolescent health can be defined as the degree to which young people are capable of accessing, reading, processing, and comprehending health information and use this information to take proper health decisions, promote and maintain their health, based on continuous interactions with their social and cultural environments. Health literacy among adolescents is influenced by a variety of factors. In the process of building and implementing health promotion campaigns for adolescents, a whole range of intrapersonal, interpersonal, and community factors have to be considered. At the very basic level, health literacy revolves around an adolescent, who has some knowledge of health and certain health management skills (Higgins et al., 2009). Adolescents use their health management skills to accumulate health knowledge which, in turn, leads to better health literacy (Sanders et al., 2009). Health literacy and adequate health decisions develop, as adolescents gradually move from concrete to abstract thinking (Higgins et al., 2009; Nutbeam, 1998). Simultaneously, adolescents usually face difficulties, trying to envision the far-reaching consequences of their actions for health. In the meantime, their functional reading and writing skills greatly affect adolescents’ ability to process health information (Higgins et al., 2009). All these aspects require detailed consideration in the process of developing health promotion campaigns for adolescents. Adolescents are extremely susceptible to peer and parent influences (Manganello, 2008). The media play a crucial role in how adolescents perceive the surrounding reality (Leger, 2001). Therefore, the concept of health literacy in adolescent health promotion should not be separated from the effects which parents and peers produce on adolescents. Parent literacy and peer behaviors altogether change and challenge the health choices adolescents make (Borzekowski, 2009; Manganello, 2008). Peers occupy a significant place in the lives of adolescents, and the concept of health literacy in promoting and maintaining adolescent health must imply that (a) adolescents recognize their influence and can distinguish correct health decisions from the incorrect ones; and (b) peers and parents are involved in the process of adolescent health improvement on a daily basis. Systems and communities are integral components of the health literacy concept in the context of adolescent health. Society, culture, the education and health systems all provide their inputs in the development of health literacy among adolescents (Manganello, 2008; Nutbeam, 2008). “Systems are an area especially important for adolescents as they are still engaged with organizations that can facilitate education programs and other interventions to enhance health literacy skills” (Manganello, 2008, p.842). Here, government health promotion decisions and the availability of health promotion opportunities for adolescents also play their role (Higgins et al., 2009). Apparently, adolescents cannot consider themselves literate, if they cannot achieve the desired state of compliance with healthy lifestyles, policies, and standards. Adolescents cannot be literate, if their schools do not allow them to eat healthy foods. Adolescents cannot be literate, if they lack access to sport and fitness infrastructures. Health literacy is the concept which empowers; therefore, there is no adolescent health literacy without a context, community, and environment. In adolescent health promotion, the concept of health literacy is often associated with the concept of risk. Risk-based conceptualizations of health literacy imply the creation of goal-directed education models, which must ensure adolescents’ compliance with the standards and behaviors recommended by clinicians (Nutbeam, 2008). The risk-related conceptualization of health literacy does little to enhance literacy among adolescents; rather, it is focused on the need to reduce illiteracy among adolescents and their peers (Nutbeam, 2008). This model of health literacy exhibits a number of serious limitations. When it comes to adolescents, it is always better to frame the concept of health literacy as an asset. The latter builds on and provides greater options for the development of self-management skills in adolescents (Nutbeam, 2008). The asset model of adolescent health literacy makes individuals more flexible, as they are navigating the health care system (Nutbeam, 2008). This conceptualization of health literacy also allows recognizing the contextual and social determinants of adolescent health (Nutbeam, 2000). Eventually, it is by conceptualizing health literacy as an asset that adolescents can expand their decision-making skills and apply them outside of the clinical settings (Nutbeam, 2008). The concept of health literacy in adolescents involves several different types of literacy. It is functional literacy, i.e., ability to read and write (Manganello, 2008). It is media literacy – “the ability to obtain and critically evaluate media messages” (Manganello, 2008). It is also interactive literacy, which means that adolescents can use their functional literacy potential to the fullest and effectively interact with the context and environment in which they live (Manganello, 2008). Here, it is important to cater health literacy in adolescents as early as possible. Adolescents actively manage their health, constantly interact with media and social messages about health, and develop productive relations with educators and health practitioners (Bozekowski, 2009). The concept of health literacy in adolescent health promotion implies that children do not simply have power and knowledge to affect health decisions but can develop full control over their health and ownership of their decisions and habits (Bozekowski, 2009). These are the best ways to ensure that health literacy works for the benefit of adolescents and fosters continuous health promotion and maintenance long-term. Conclusion Health literacy and adolescent health are directly related. the concept of health literacy in adolescents can be defined as the degree to which young people are capable of accessing, reading, processing, and comprehending health information and use this information to take proper health decisions, promote and maintain their health, based on continuous interactions with their social and cultural environments. The concept of health literacy in promoting and maintaining adolescent health should be treated as an asset, which continuously evolves and allows using adolescent decision-making and self-management skills beyond educational and clinical settings. The concept of health literacy in adolescent health promotion must ensure that adolescents develop full control over their health and ownership of their decisions and habits. This is how health literacy can work for the benefit of adolescents and foster continuous health promotion and maintenance long-term. 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