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

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          Abstract

          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.

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          Most cited references44

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          Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation.

          Protocols of systematic reviews and meta-analyses allow for planning and documentation of review methods, act as a guard against arbitrary decision making during review conduct, enable readers to assess for the presence of selective reporting against completed reviews, and, when made publicly available, reduce duplication of efforts and potentially prompt collaboration. Evidence documenting the existence of selective reporting and excessive duplication of reviews on the same or similar topics is accumulating and many calls have been made in support of the documentation and public availability of review protocols. Several efforts have emerged in recent years to rectify these problems, including development of an international register for prospective reviews (PROSPERO) and launch of the first open access journal dedicated to the exclusive publication of systematic review products, including protocols (BioMed Central's Systematic Reviews). Furthering these efforts and building on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, an international group of experts has created a guideline to improve the transparency, accuracy, completeness, and frequency of documented systematic review and meta-analysis protocols--PRISMA-P (for protocols) 2015. The PRISMA-P checklist contains 17 items considered to be essential and minimum components of a systematic review or meta-analysis protocol.This PRISMA-P 2015 Explanation and Elaboration paper provides readers with a full understanding of and evidence about the necessity of each item as well as a model example from an existing published protocol. This paper should be read together with the PRISMA-P 2015 statement. Systematic review authors and assessors are strongly encouraged to make use of PRISMA-P when drafting and appraising review protocols. © BMJ Publishing Group Ltd 2014.
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            Health literacy and public health: A systematic review and integration of definitions and models

            Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.
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              Literacy and health outcomes: a systematic review of the literature.

              To review the relationship between literacy and health outcomes. We searched MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resources Information Center (ERIC), Public Affairs Information Service (PAIS), Industrial and Labor Relations Review (ILLR), PsychInfo, and Ageline from 1980 to 2003. We included observational studies that reported original data, measured literacy with any valid instrument, and measured one or more health outcomes. Two abstractors reviewed each study for inclusion and resolved disagreements by discussion. One reviewer abstracted data from each article into an evidence table; the second reviewer checked each entry. The whole study team reconciled disagreements about information in evidence tables. Both data extractors independently completed an 11-item quality scale for each article; scores were averaged to give a final measure of article quality. We reviewed 3,015 titles and abstracts and pulled 684 articles for full review; 73 articles met inclusion criteria and, of those, 44 addressed the questions of this report. Patients with low literacy had poorer health outcomes, including knowledge, intermediate disease markers, measures of morbidity, general health status, and use of health resources. Patients with low literacy were generally 1.5 to 3 times more likely to experience a given poor outcome. The average quality of the articles was fair to good. Most studies were cross-sectional in design; many failed to address adequately confounding and the use of multiple comparisons. Low literacy is associated with several adverse health outcomes. Future research, using more rigorous methods, will better define these relationships and guide developers of new interventions.
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                Author and article information

                Journal
                Iran J Public Health
                Iran J Public Health
                IJPH
                IJPH
                Iranian Journal of Public Health
                Tehran University of Medical Sciences
                2251-6085
                2251-6093
                March 2021
                : 50
                : 3
                : 448-458
                Affiliations
                [1. ]Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
                [2. ]Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
                [3. ]Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
                Author notes
                [* ] Corresponding Author: Email: peymann@ 123456mums.ac.ir
                Article
                IJPH-50-448
                10.18502/ijph.v50i3.5584
                8214623
                34178792
                f1923342-27b8-4dc5-868a-10112776f4c6
                Copyright © 2021 Jafari et al. Published by Tehran University of Medical Sciences

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license ( https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.

                History
                : 11 August 2020
                : 12 October 2020
                Categories
                Review Article

                Public health
                public health,systematic review,schools, children,adolescent,health literacy
                Public health
                public health, systematic review, schools, children, adolescent, health literacy

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