ArticleThe Journal of school health2021
Low Health Literacy Is Associated With Energy-Balance-Related Behaviors, Quality of Life, and BMI Among Rural Appalachian Middle School Students: A Cross-Sectional Study.
Article in The Journal of school health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 22 citations in OpenAlex.
- Comparison of Researcher-Led versus Teacher-Led effectiveness and fidelity: A Hybrid Type 1 study of Kids SIPsmartER in Appalachia middle schools.Translational behavioral medicine · 2024Trial
- Systematic Review of Health Literacy and Health Behavior in Adolescents Research.Epidemiologia (Basel, Switzerland) · 2026Review
- An investigation into the prevalence and perceptions of mental health disorders in Appalachian West Virginia.Discover mental health · 2025Article
- Association between Health Literacy and Sugar-sweetened Beverage Consumption among Filipinos.Acta medica Philippina · 2025Article
- Behavioral correlates of health literacy among university students of health sciences in Kosovo: a cross-sectional study.Croatian medical journal · 2024Article
- Student and caregiver acceptability of a school-based intervention to improve sugar-sweetened beverage behaviors: a mixed methods study.Health education research · 2024Article
- Article
- Enhancing nutritional knowledge and self-regulation among adolescents: efficacy of a multifaceted food literacy intervention.Frontiers in psychology · 2024Article
- Unpacking the Public Health Triad of Social Inequality in Health, Health Literacy, and Quality of Life-A Scoping Review of Research Characteristics.International journal of environmental research and public health · 2023Article
- Factors related with nursing students' health literacy: a cross sectional study.Frontiers in public health · 2023Article
- Association between low health literacy and adverse health behaviors in North Carolina, 2016.Journal of Appalachian health · 2023Article
- Health Literacy and Health-Related Quality of Life in Beijing Adolescents: A Path Analysis.Health literacy research and practice · 2022Article
- The relationship between health literacy and health-related quality of life among school-aged children in regional China.Health and quality of life outcomes · 2021Article
- Socio-Economic Determinants of Health Literacy in High School Students: A Cross-Sectional Study.International journal of environmental research and public health · 2021Article
- Health Literacy and Health Behavior: Associated Factors in Surabaya High School Students, Indonesia.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundMany studies document associations between low health literacy (HL) and poor health behaviors and outcomes. Yet, HL is understudied among adolescents, particularly from underserved, rural communities. We targeted rural adolescents in this cross-sectional study and explored relationships between HL and (1) energy-balance-related health behaviors and (2) body mass index (BMI) and quality of life (QOL).
methodsSurveys were administered to 7th graders across 8 middle schools in rural Appalachia. HL was assessed using the Newest Vital Sign. Energy-balance-related behaviors and QOL were assessed using validated instruments. Height and weight were objectively measured. Analyses were conducted using the Hodges-Lehmann nonparametric median difference test.
resultsOf the 854 adolescent students (mean age = 12; 55% female), 47% had limited HL. Relative to students with higher HL, students with lower HL reported significantly lower frequency of health-promoting behaviors (water, fruit and vegetable intake, physical activity, sleep), higher frequency of risky health behaviors (sugar-sweetened beverages, junk food, screen time), and had higher BMI percentiles and lower QOL (all p < .05).
conclusionsLow HL is associated with energy-balance-related behaviors, BMI, and QOL among rural, Appalachian adolescents. Findings underscore the relevance of HL among rural middle school students and highlight implications for school health.
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