Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK

Bibliographic Data

ID22945499
AuthorsEmily Marchant (0000-0002-9701-5991, Swansea University), Emily Lowthian (0000-0001-9362-0046, Swansea University), Michaela James (0000-0001-7047-0049, National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea University , Swansea, SA2 8PP), Nia Davies (0000-0002-3064-3176, Swansea University), Nia A Davies (0009-0008-9697-4438, Swansea University), Timothy Crick (0000-0001-5196-9389, Swansea University), Tom Crick (Swansea University)
Year2025
Volume40
Issue2
Publication date2025-03-05
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Promotion International (JOURNAL)
Journal identifiersISSN: 0957-4824 • E-ISSN: 1460-2245
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1093/heapro/daaf026
PMID40208189
OpenAlexW4409333132
LanguageEN
References cited71

Childhood is a period of significant formative development where knowledge, skills, and capacities for adequate health literacy are acquired, particularly within school settings. The new Curriculum for Wales (CfW), phasing in from September 2022 for learners aged 3–16 years, places statutory focus on health and well-being and school-level curriculum design, providing unprecedented opportunities to empower children as agents in making health-enhancing decisions. Designing, tracking, and evaluating impacts of the CfW on children’s health literacy requires scalable monitoring tools; however, research efforts have focused on adolescent populations. This national-scale scoping and pilot study, the first to explore children’s health literacy in Wales, piloted the Health Literacy for School-Aged Children (HLSAC-5) within the existing nationwide Health and Attainment of Pupils in Primary EducatioN (HAPPEN-Wales) health and well-being survey to examine the health literacy of children aged 8–11 (n = 2607) and explore associations between health literacy and health behaviours. Children’s health literacy was categorized as low (22.6%), moderate (50.4%), and high (27.0%). Multinomial logistic regression analyses suggest high health literacy compared to low health literacy was associated with higher sleep [relative risk ratio (RRR): 1.08, 95% CI 1.01–1.15], higher weekly physical activity (RRR: 1.13, 95% CI 1.03–1.25), fewer sedentary days per week (RRR: 0.89, 95% CI 0.81–0.99), and higher health-related well-being (RRR: 1.35, 95% CI 1.27–1.44). This study offers a sustainable measure of pre-adolescent children’s health literacy and health behaviours and tracking of CfW impacts. This enables efforts to be tailored to person-centred (understanding children’s health literacy needs), place-based (examining specific organizational health literacy context within schools and CfW design), and policy-focused approaches (re-energizing health literacy within current/emerging policies in Wales including the CfW).

Curriculum · Environmental health · Health care · Health education · Health literacy · Literacy · Pedagogy · Political science · Public health · Breastfeeding Practices and Influences · Health Literacy and Information Accessibility · Medicine · Mobile Health and mHealth Applications · Nursing · Psychology