The association between teacher academic support and health literacy among 13- and 15-year olds: Finnish HBSC-study

Author(s):

Leena Paakkari(presenting / submitting)Raili Välimaa(presenting)Olli Paakkari Jari Villberg Jorma Tynjälä Kristiina Ojala

Conference:

ECER 2017

Network:

08. Research on Health Education

Format:

Paper

Session Information

08 SES 10, Educational Perspectives on Health Literacy and Action Competence

Paper Session

Time:

2017-08-24

15:30-17:00

Room:

K3.24

Chair:

Monica Carlsson

Contribution

Adolescence is an important period of time to laid the foundation for health literacy, health behaviour, and health and well-being in general (Paakkari et al., 2016a). During those years the children get ever greater autonomy in respect taking caring of their health, and in general, independence of decision-making increases (Ghanbari et al., 2016). Health inequalities of adult population can be partly explained with health behaviours adopted in adolescence and with early life circumstances (Inchley et al., 2016, 5).

Education has been clearly linked to health and its determinants (UNESCO, 2016, p. 7). Recently published report of UNESCO (2016) highlight that skills-based education is needed to raise awareness about various health topics such as risks of substance use as well as to support the development of competencies relevant for promoting one’s health (i.e. health literacy). School comprises a valuable setting for supporting the development of such competencies, since the school reaches most of the population within a certain age demographic.

Good health literacy has been related to various positive health outcomes such as less risk-taking (DeWalt & Hink, 2009; Sanders et al., 2009), having more health-related knowledge (DeWalt & Hink, 2009) and healthy behaviours, like non-smoking (Berkman et al., 2004; DeWalt & Hink, 2009; Sanders et al., 2009). However, these arguments are based on the research mainly done about functional health literacy, that is, a skills of reading, writing and numeracy (Parker et al., 1995). There is a clear call for the research that examines adolescents’ broader notion of health literacy. One of the few of such studies is that of Paakkari et al. (2016b). They found out that approximately every third adolescents reported high perceived health literacy, and one tenth reported low health literacy. Boys’ health literacy level was lower than girls’, as well as 7th graders than 9th graders. Also, the health literacy was better among pupils’ from high affluent families, who succeeded well at school and who planned to continue to upper secondary education instead of for example vocational training.

Though school’s role in developing health literacy has been recognized, the research examining the link between teacher’s practices and pupils health literacy is rare. The aim of this research is to study how school-related factors, and more specifically teacher academic support, are related to subjective health literacy among Finnish 13- and 15- years-old pupils with different kind of background factors (age, gender, FAS, educational aspiration, learning difficulties and school achievement).

Method

Health Behaviour in School-aged Children Study (HBSC) in Spring 2014 was used as a means to collect the data. The nationally representative sample consisted in total 3853 pupils (13-year-olds, n=1918, 15-year-olds, n=1935) from 359 schools. Health literacy was measured using the Health Literacy for School-aged Children (HLSAC) -instrument (Paakkari et al., 2016a). The ten questions took the form “I am confident that…”, and continued with items such as “I can judge how my behaviour affects my health”. The answering options were: “not at all true”, “barely true”, “somewhat true”, and “absolutely true”. The response options 1 and 2 were combined in order to better summarise the findings (Paakkari et al., 2016b). Students’ perceptions on academic support by teacher(s) were measured by eight questions (e.g “My teachers make sure that I really understand my goals and what I need to do”), and students expressed the degree to which they agreed with the statements: “strongly agree”, “agree“, “don’t know“, ”disagree”, and “strongly disagree”. Learning difficulties were assessed by asking pupils’ to indicate if they have had learning difficulties in two areas: in reading or spelling, or in math. Possible response options for both questions were “no”, “some” and “yes”. School children’ school achievement was measured using grades both for the first language and for mathematics. The question here was framed as “In my latest school report the mark was…” The response scales covered marks from 4 (fail) to 10 (excellent). The grades for both subjects were grouped together (sum score of both grades, divided by two in order to maintain the range from 4 to 10), to represent broader academic achievement. By a question concerning what students will do when they finish comprehensive school assessed educational aspirations. Only the options “upper secondary school” and “vocational school or other” were included to statistical analysis because of very low frequencies of other responses. The family affluence scale (FAS III) was used as an indirect measure of family wealth (Torsheim et al., 2015). The individual's responses to six items are scored and summed, and compared to other scores in a given country or region. FAS is used to identify groups of young people in the lowest 20% (low affluence), middle 60% (medium affluence), and highest 20% (high affluence)” (Inchley et al., 2016, p. 17). Cross-tabulations, chi-square tests and multilevel analyses were applied.

Expected Outcomes

Preliminary results show that there is an association between teacher’s academic support and pupils’ perceived health literacy. The pupils who considered their teachers’ support good reported higher levels of health literacy. Further examination will focus on answering who are the pupils who benefit most of the teacher’s academic support from the perspective of health literacy. Especial focus will be put on gender, learning difficulties, family affluence and school achievement. The findings received so far let us assume that certain pedagogical elements may contribute to gaining of better health literacy. These are for instance the following ones: the teacher should start from what children know and think before suggesting new contents and methods, encourage children to express their own opinions, take into account how children would like to perform the task, make sure that children really understand the objective of the task and what they have to do, and accept children as they are. Such findings offer important information for teachers and teacher educators involved in school health education.

References

Berkman, N. D., DeWalt, D. A., Pignone, M. P., Sheridan, S. L., Lohr, K. N., Lux, L., ... & Bonito, A. J. (2004). Literacy and health outcomes. Evidence report/technology assessment, 87, 1-8. DeWalt, D. A., & Hink, A. (2009). Health literacy and child health outcomes: a systematic review of the literature. Pediatrics, 124(Supplement 3), S265-S274. Ghanbari, S., Ramezankhani, A., Montazeri, A., & Mehrabi, Y. (2016). Health Literacy Measure for Adolescents (HELMA): Development and Psychometric Properties. PloS one, 11(2), e0149202. Inchley J, Currie D, Young T, Samdal O, Torsheim T, Augustson L, Mathison F, Aleman-Diaz A, Molcho M, Weber M and Barnekow V. (eds) (2016). Growing up unequal: gender and socioeconomic differences in young people's health and well-being. Health Policy For Children and Adolescents, no 7, 2016. Copenhagen: World Health Organization. Paakkari, O., Torppa, M., Kannas, L., & Paakkari, L. (2016a). Subjective health literacy: Development of a brief instrument for school-aged children. Scandinavian Journal of Public Health, 44(8), 751-757. Paakkari O, Torppa M, Kannas L and Paakkari L. (2016b). Subjective health literacy among school-aged children and its associations with school achievement, learning difficulties, educational aspirations, and family affluence (submitted) Parker, R. M., Baker, D. W., Williams, M. V., & Nurss, J. R. (1995). The test of functional health literacy in adults. Journal of general internal medicine, 10(10), 537-541. Sanders, L. M., Federico, S., Klass, P., Abrams, M. A., & Dreyer, B. (2009). Literacy and child health: a systematic review. Archives of pediatrics & adolescent medicine, 163(2), 131-140. Torsheim, T., Cavallo, F., Levin, K.A., Schnohr, C., Mazur, J., Niclasen, B., & Currie, C. (2015). Psychometric validation of the revised family affluence scale: a latent variable approach. Child Indicators Resesearch, 9, 771—784. UNESCO, 2016. UNESCO strategy on education for health and well-being: contributing to the Sustainable Development Goals. Paris.

Author Information

Leena Paakkari (presenting / submitting)

University of Jyväskylä

Faculty of Sport and Health Sciences

Jyväskylä

Raili Välimaa (presenting)