Health literacy in adolescents with chronic disease during transition

The transition from pediatric to adult-oriented healthcare is a major challenge, and adequate health literacy is essential for achieving a smooth transition. However, knowledge is scant regarding adolescents' health literacy during this period, and research that includes both adolescents and their parents remains limited.

This study clarified the health literacy of adolescents with chronic illnesses and their parents and examined differences between adolescents' self-assessments and parents' evaluations.

A cross-sectional survey was conducted with 111 adolescent-parent dyads from two hospitals in Japan. The Japanese version of the 14-item Health Literacy Scale (HLS-14) assessed functional, communicative, and critical literacy. Parents also evaluated their adolescents' literacy. Descriptive statistics, Pearson's correlations, paired t-tests, and intraclass correlation coefficients (ICC) were used.

Adolescents showed moderate literacy levels across domains (functional: M=21.18/25; communicative: M=14.6/25; critical: M=13.1/20). Functional literacy developed independently, while communicative and critical literacy were strongly correlated. Parents demonstrated lower literacy than general adult norms, particularly in communicative and critical domains. Agreement between parent ratings and adolescents' self-reports was fair (ICC=0.35-0.42), indicating limited correspondence.

Domain-specific strategies are needed to foster adolescent health literacy. Communicative and critical literacy require intentional educational support beyond basic reading and writing. Given parents' relatively low literacy, transition programs should incorporate parent-focused resources. Improving health literacy in both adolescents and their parents may support a smoother transition to adult-oriented care and promote independent disease management; however, further research is needed to better understand and support this process.