A study on constructing Taiwan children's health literacy ability from health promotion view

Health literacy has been proven related to health inequality, poor health behavior, and health status. Current health literacy is measured mostly on adults based on a medical view internationally; it is imperative to understand children's health life experience and situation in which they live, thus this study attempts to construct elementary school 6th graders' health literacy ability in Taiwan. This study proceeded in 3 stages. In Stage I, in-depth interviews were conducted with 10 teachers and 11 parents, and focus group interviews with 30 children, in order to understand the situations and difficulties related to children's health. Stage II identified the literacy corresponding to every real-life situation from life skills proposed by the WHO and the Taiwanese grade 1-9 Curriculum Guidelines for health education. Stage III redefined children health literacy from a health promotion perspective through expert meeting and confirmed indicators by 2 Delphi surveys with 21 health education researchers, experts and teachers. This study constructed 25 “children health literacy ability indicators”, including: 11 Functional Health Literacy (e.g. understands the connection between personal health care behavior and health), 7 Interactive Health Literacy (e.g. obtains and understands information from various channels), and 7 Critical Health Literacy (e.g. analyzes the relationship between personal needs and diet choice for a balanced diet). These indicators cover 10 health education categories. Based on WHO's health promotion perspective, this study proposed an operational definition of 3 aspects of health literacy to serve as an importance basis for development of Taiwan children health literacy scale.