Health literacy and health behavior in adolescence: results of a nationwide online survey among adolescents

Olga Maria Domanska, Anne-Kathrin M. Loer, Christiane Stock und Susanne Jordan


There is lack of information about the association between health literacy and health behavior in Germany, although strengthening health literacy is regarded as a promising approach to promote health behavior, especially for young people in adolescence.


This study examined the extent to which different dimensions of generic health literacy are associated with health behavior among adolescents, considering also sociodemographic factors and self-efficacy.

Material and methods

Data are based on a nationwide online survey on “Health literacy among adolescents” (GeKoJu) with 1235 adolescents aged between 14 and 17 years in Germany. Data of four dimensions of generic health literacy were collected with the self-report measurement tool “Measurement of Health Literacy Among Adolescents Questionnaire” (MOHLAA-Q). Health behavior was examined with questions on sports, diet, alcohol consumption and smoking. Univariate and bivariate analyses as well as multiple regression analyses were conducted.


Adolescents with low levels in all examined health literacy dimensions had increased odds of not consuming fruit and vegetables daily. The odds of smoking or not exercising were also higher among those with lower communication and interaction skills and passive attitudes toward health and health information. Risky alcohol consumption was not associated with health literacy.


The findings suggest the strengthening of active attitudes toward health and health information and communication and interaction skills regarding health-related topics for promoting health behavior among adolescents.