Adolescent Health Literacy in Beijing and Melbourne: A Cross-Cultural Comparison

While adolescent health literacy has gained momentum, it is under-researched from a cross-cultural perspective. This study aims to compare health literacy among two cultural groups of secondary students in Beijing and Melbourne. A cross-sectional study was conducted with 770 students from five secondary schools in Beijing and Melbourne. A self-administered questionnaire was designed to collect information on health literacy (the eight-item health literacy assessment tool (HLAT-8), the Newest Vital Sign (NVS) and the 47-item Health Literacy Survey (HLS-47)), its antecedents and health outcomes. Overall, students&rsquo
health literacy in Melbourne (n = 120) was higher than that in Beijing (n = 650): 28.25 ±
6.00 versus 26.37 ±
5.89 (HLAT-8)
and 4.13 ±
1.73 versus 3.65 ±
1.64 (NVS). The proportion of students with low health literacy varied by instruments, representing 23.7&ndash
32.2% in Melbourne and 29.0%&ndash
45.5% in Beijing. In both cultural groups, students&rsquo
self-efficacy, social support, and perceptions of school environment were associated with their health literacy, which in turn predicted their health behaviours, patient-provider communication and health status. Given the nature of our study design and small samples, a cautious conclusion would be that adolescent health literacy is sensitive to the broad cultural context and might be an interactive outcome influenced by an individual&rsquo
s health skills and the social environment. Particularly, creating a supportive school environment is critical to develop adolescent health literacy that would eventually contribute to better health outcomes.