A path model to test the intermediate factors of the relationships between health literacy and health status among adolescents in Taiwan

Health literacy is an important issue in public health today, especially as patients are taking a greater role in obtaining information to promote their health. However, limited studies tested the intermediated factors of the relationships between health literacy and health status for adolescents. In this study, we test an exploratory path model by examining the relationship between health literacy and health status among Taiwan adolescents while online information use, physician-patient communication and health promoting behaviors are treated as possible intermediating variables. A cross-sectional survey with self-reported questionnaires was conducted. Using the multistage cluster sampling method, 413 adolescents participated in this study. According to the casual pathway of the path model, health literacy did not directly influence health status. Only health promoting behavior could directly influence self-rated health status. There was significant, direct path from educational attainment of father to health literacy. Additional significant paths included health literacy to physician-patient communication; physician-patient communication to health promoting behavior; online information use to health promoting behavior. School health professionals could teach more communication skills based on the concept of HL to improve better capacities of adolescents as to perform good interaction with physicians and to adopt healthy behavior to promote health.