The Status of Health Literacy in Students Aged 6 to 18 Old Years: A Systematic Review Study

Background: Adolescents and children are a core target population for health literacy (HL) studies and practice. There is limited knowledge regarding the HL skills and abilities that help young people and children in making health decisions. This study aimed to evaluate the status of HL in ongoing school students. Methods: Literature searching was performed using nine databases (Web of Science, PubMed, Scopus, Google Scholar, Iranmedex, Magiran, Scientific Information Database) without restriction in time until January 2019, and database searches were supplemented with reference hand searches and gray literature. Cross-sectional and experimental studies with focuses on validated measures of HL in ongoing students were included. Results: This systematic review of identified 17 studies and 199714 samples specifically studied on ongoing school students aged 6-18 years. Students and their mothers have a moderate level of HL in four dimensions of menstrual health, physical activity, breast self-test, and iron deficiency anemia, and most of them have a high level of HL only in terms of nutrition. The relationship of HL with health outcomes, health promotion behaviors, self-efficacy, self-mutilating behaviors, and self-care abilities was statistically significant. HL status is related to parents' education level, socio-economic determinants (culture, family income, and environmental contextual factors), age groups, and media/digital communication channels. Conclusion: This review identified seven main determinates that significantly affect HL status in the target group. This systematic review shows most of the ongoing school students had an inadequate level of HL skills. HL strategies have a potential impact on improving students' health behaviors and life quality.