Abstract

The improvement of children’s health literacy is crucial for their physical and mental health development, and exploring the internal pathway of health literacy by age group is essential for improving the health literacy level at different age stages. We explored internal pathways within health literacy among elementary school students at different grade levels, utilizing a mediated effects model. A total of 3325 Chinese elementary students participated in a cross-sectional study between January to July 2023 using Health Literacy Questionnaire. IBM SPSS V.27 was used for descriptive statistics and correlation analysis of all variables. PROCESS SPSS was used to analyze chain-mediated effects. In grades 1-2, health motivation correlated with health participation through two paths: the mediating role of health skill, and the serial mediating roles of health knowledge and skill, presenting a partial mediating effect. In grades 3-4, health knowledge correlated with health participation through two paths: the mediating role of health motivation, and the mediating role of health skill, presenting a partial mediating effect. In grades 5-6, health knowledge correlated with health participation through one path: the mediating role of health motivation, presenting a total mediating effect. Our study suggests that elementary school students at different grade levels have different ways of improving health literacy because of the different pathways within health literacy. This provides new ideas for health education among children.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This work was supported by the Science and Technology Innovation Project in Medicine and Health, Chinese Academy of Medical Sciences under Grant [number 2021-I2M-1-046]; the National Natural Science Foundation of China under Grant [number 71904205].

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

the Institutional Review Board of the Chinese Academy of Medical Sciences & Peking Union Medical College

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Data Availability

All data produced in the present study are available upon reasonable request to the authors

Abbreviations(HL)Health Literacy;(HPS)Health Promoting School;(HK)Health knowledge;(HM)Health Motivation;(HS)Health Skill;(HP)Health Participation;(IMB)Information-Motivation-Behavioral Model;(SDT)Self-Determination Theory