Nursing Interventions to Promote Health Literacy in Children and Adolescents: A Scoping Review

Background/Objectives: Health literacy (HL) is recognized as an important social determinant of health. It supports healthy behaviors and effective health management throughout one's life. For children and adolescents, developing HL influences their well-being, development, and ability to make informed health decisions. Nurses are strategically positioned to promote HL from an early age. To our knowledge, no prior synthesis has specifically examined nurse-led HL interventions targeting pediatric populations, highlighting the originality and relevance of this scoping review. The purpose of this review was to map and characterize nursing interventions aimed at improving HL outcomes in children and adolescents. Methods: A scoping review was conducted according to the Joanna Briggs Institute methodology, using a three-step search strategy, and reported in accordance with the PRISMA-ScR guidelines. Searches were conducted in MEDLINE, CINAHL, Scopus, Web of Science, and ProQuest with no date restriction, including studies published in Portuguese, English, or Spanish. Studies involving children and adolescents (ages 0-18) in any healthcare or community setting were eligible. Data on intervention characteristics and HL outcomes were extracted and analyzed descriptively, and no critical appraisal of the included sources was conducted. Results: A total of 44 studies were included. Interventions were predominantly school-based and focused on adolescents (n = 26), with a clear gap in early childhood (n = 2). Studies of early childhood primarily used storytelling and reading activities, whereas interventions targeting older children and adolescents more often employed participatory educational strategies, group-based approaches and digital platforms. The most frequently addressed topics were chronic disease management (n = 12), mental health (n = 7), and nutrition (n = 5). HL domains mainly focused on healthcare and health promotion, with fewer studies addressing disease prevention. Most interventions were conducted in school settings (n = 24), highlighting this context over those in primary care, community, and hospital settings. Conclusions: The results revealed nursing interventions used to promote HL, particularly in the management of chronic diseases, mental health and nutrition. However, the existing body of research is still limited. Key gaps include the absence of standardized measurement tools and the scarcity of longitudinal studies evaluating long-term outcomes. These limitations constrain the comparability and generalizability of findings, highlighting the necessity of more rigorous, methodologically robust research to support evidence-based practices. This scoping review comprehensively maps nurse-led interventions that promote HL among children and adolescents, identifying key priorities to guide future research in this area.