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Peer-reviewedCC BY 4.0Frontiers in Public Health

Health literacy among adolescents: a cluster analysis

  • Solveig Veshovda1
  • Kåre Rønn Richardsen2
  • Marit Helen Andersen3,4
  • Britt Elin Øiestad1
  • Hedda Eik1,3
  • Kirsti Riiser1,5
5 affiliations
  1. 1Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University
  2. 2Faculty of Health and Social Sciences, University of South-Eastern Norway
  3. 3Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo
  4. 4Department of Transplantation Medicine, Oslo University Hospital
  5. 5Department of Child and Adolescent Health Promotion Services, Norwegian Institute of Public Health
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Abstract

Background: Adolescents represent a critical target group for health literacy (HL) research, as this stage of life involves increasing independence and responsibility for personal health behaviors. The growing burden of health challenges among adolescents highlights the importance of HL, as it equips individuals to navigate such challenges and actively engage with their health. Despite growing recognition of HL as a critical determinant of health, research on adolescent HL remains limited. This study aimed to describe HL among adolescents aged 14–16 years and to identify and characterize HL cluster affiliations.

Materials and methods: This cross-sectional study included adolescents aged 14–16 years across six schools in Southern Norway. Data were collected between March and September 2023 using a web-based questionnaire. The study employed the Health Literacy for School-Aged Children (HLSAC) instrument (range 10–40). HL clusters were identified based on the instrument’s five core HL components (theoretical knowledge, practical knowledge, individual critical thinking, self-awareness, and citizenship) using Ward’s method. We employed multiple multinomial regression analyses to examine factors associated with different cluster affiliations.

Results: The total sample’s ( n = 440) mean score for HL was 31.6. The analysis indicated four HL clusters, reflecting ordered levels of HL, from low (Cluster A) to high (Cluster D). Adolescents with higher academic ambitions and fathers with a higher educational level had a lower relative risk (RRR) of being affiliated with the lowest HL cluster. Males had a lower RRR than females of being affiliated with the second-lowest HL cluster compared to the highest HL cluster.

Conclusion: This study used cluster analysis to examine HL among adolescents, identifying four HL clusters ranging from low to high. The findings reveal social influences on HL, such as academic ambition and parental education, and how health determinants might shape its distribution at the population level. These data-driven insights underscore the need for further research into health outcomes.

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Cite

BibTeXRIS
BibTeX
@article{veshovda2026health,
  title = {{Health literacy among adolescents: a cluster analysis}},
  author = {Solveig Veshovda and Kåre Rønn Richardsen and Marit Helen Andersen and Britt Elin Øiestad and Hedda Eik and Kirsti Riiser},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1853107},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1853107/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Health literacy among adolescents: a cluster analysis
AU  - Solveig Veshovda
AU  - Kåre Rønn Richardsen
AU  - Marit Helen Andersen
AU  - Britt Elin Øiestad
AU  - Hedda Eik
AU  - Kirsti Riiser
PY  - 2026
DA  - 2026/10/20
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1853107
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1853107/full
AB  - Background: Adolescents represent a critical target group for health literacy (HL) research, as this stage of life involves increasing independence and responsibility for personal health behaviors. The growing burden of health challenges among adolescents highlights the importance of HL, as it equips individuals to navigate such challenges and actively engage with their health. Despite growing recognition of HL as a critical determinant of health, research on adolescent HL remains limited. This study aimed to describe HL among adolescents aged 14–16 years and to identify and characterize HL cluster affiliations.  Materials and methods: This cross-sectional study included adolescents aged 14–16 years across six schools in Southern Norway. Data were collected between March and September 2023 using a web-based questionnaire. The study employed the Health Literacy for School-Aged Children (HLSAC) instrument (range 10–40). HL clusters were identified based on the instrument’s five core HL components (theoretical knowledge, practical knowledge, individual critical thinking, self-awareness, and citizenship) using Ward’s method. We employed multiple multinomial regression analyses to examine factors associated with different cluster affiliations.  Results: The total sample’s ( n = 440) mean score for HL was 31.6. The analysis indicated four HL clusters, reflecting ordered levels of HL, from low (Cluster A) to high (Cluster D). Adolescents with higher academic ambitions and fathers with a higher educational level had a lower relative risk (RRR) of being affiliated with the lowest HL cluster. Males had a lower RRR than females of being affiliated with the second-lowest HL cluster compared to the highest HL cluster.  Conclusion: This study used cluster analysis to examine HL among adolescents, identifying four HL clusters ranging from low to high. The findings reveal social influences on HL, such as academic ambition and parental education, and how health determinants might shape its distribution at the population level. These data-driven insights underscore the need for further research into health outcomes.
SN  - 2296-2565
ER  -