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The study explored the latent construct underlying the assessment conceptions and practices of Finnish Health Education teachers (n = 165) in the context of curricula, seeking thereby to identify the teachers' assessment profiles. Six underlying factors were found to encompass their assessment conceptions and practices, namely "Assessment supporting learning," "Assessment of working," "Self and peer assessment as part of grading," "Common assessment criteria," "Questionable assessment practices," and "Norm-referenced assessment." Via cluster analysis, three distinct assessment profiles were identified, labeled as "Problematic assessors," "Learning supportive assessors," and "Norm-based assessors." These findings can be used to develop Health Education teacher training and facilitate teachers' assessment literacy.

Purpose: The purpose of this paper is to explore Finnish adolescents' subjective health literacy (HL) in association to school achievement, learning difficulties, educational aspirations, and family affluence. Design/methodology/approach: Nationally representative data were collected in Finland as a part of the international Health Behaviour in School-aged Children study. The respondents consisted in total of 3,833 adolescents (7th and 9th graders) from 359 schools. The Health Literacy for School-aged Children instrument was applied to measure adolescents' subjective HL, while the Family Affluence Scale was used to measure adolescents' socioeconomic status. Information was gathered on school achievement, learning difficulties, and educational aspirations. Findings: Approximately one-third of the adolescents manifested a high level of HL, around 60 per cent had a moderate level of HL, and about one-tenth had low HL. The HL level was lower for boys than for girls, and lower for 7th graders than for 9th graders. In the total sample, the strongest explanatory variables for HL were school achievement in the first language, and educational aspirations. Originality/value: This study provides the first nationally representative examination of adolescents' subjective HL levels, and how these vary across age and gender groups. In drawing conclusions and presenting suggestions for HL interventions, it is important to verify the nature of the HL examined in any given study, and how it was researched.

Purpose: The purpose of this paper is to discuss the findings of an intervention program built on the concept of children's health literacy, particularly on its citizenship component. This intervention program employed the Investigation-Vision-Action-Change model for action-oriented teaching, where children were supported to investigate different health issues that affect them, create visions about desirable changes, and act toward desirable change. The intervention was implemented in the conditions of a post-communist country (Slovakia) where the majority of health education programs are behaviorally oriented, without giving space to children's own perceptions and decisions. The study seeks to explore whether fostering children's participation in forming the school environment improves the three selected factors of school well-being, namely, children's perception of school, their subjective well-being, and violent behavior in school. Design/methodology/approach: A cluster-randomized controlled trial design was used where ten classes of children aged nine to ten years were randomly assigned to either experimental (n = 89) or control group (n = 96). The dependent variables were pre- and post-tested using measures drawn from the Health Behavior in School-aged Children study for Slovakia. Findings: The intervention program was shown to yield empirically robust effects, given the significant improvement in children's perceptions about school, violent behavior, and their well-being, with medium-to-large effect sizes (Hedges's g ranging from 0.74 to 0.96). Originality/value: The present study offers an effective approach to enhance the respect for the children's views on issues that affect them, particularly within post-communist conditions.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus in the coronavirus family, causing the coronavirus disease (COVID-19). Biomedical vaccines are key but alongside biomedical vaccines, a social vaccine can be similarly useful to prevent infection from SARS-CoV-2, if applied as a health promotion strategy. In order to slow down and control the spread of SARS-CoV-2, applying the social vaccine concept should be considered in parallel. From a health promotion perspective, a social vaccine is a process of social and political mobilization driven by governmental and non-governmental organizations aiming at populations by applying interventions such as health communication, education and mass media campaigns as well as determinant-based programs to address environmental factors influencing personal behavior and community capacities to cope with and overcome the societal burdens of COVID-19. In this context, health literacy is significant, as seen in the role it plays in empowering citizens during the COVID-19 pandemic and enabling them to deal with health information considering COVID-19. As a public health strategy, health literacy as a social vaccine will enable individuals and communities to mitigate the spread of the virus by understanding and applying information as provided through governments and health authorities. The aim of this article is to explore health literacy as a promising social vaccine and opportunity to utilize social vaccination and thus be considered as a key public health approach—both bottom-up and top-down—to support the combat of COVID-19 and future states of emergency. [ABSTRACT FROM AUTHOR]

This paper addresses the critical role of health literacy during the COVID-19 infodemic and provides recommendations for decision-makers regarding how health literacy can be advanced as an empowering resource to mitigate the harmful effects of future infodemics. Based on a comprehensive literature review, key areas concerning health literacy are identified that help provide a strategic response during an infodemic. A framework for systemic health literacy capacity and policy advice is presented to inform and guide decision-makers on managing an infodemic with health literacy strategies. The way forward includes emphasizing the rights to access information and a broader view of how health literacy can help build back better in the aftermath of the COVID-19 pandemic. Finally, the paper includes a call to action for decision-makers to integrate systemic health literacy responsiveness into public health emergency strategies to counter a future infodemic's diffusion. [ABSTRACT FROM AUTHOR]

The aim of this phenomenographic study was to identify student teachers' ways of experiencing the teaching of health education, and to determine the aspects that are educationally critical in gaining a deeper understanding of the teaching. Qualitative data (written essays, semi-structured interviews) were gathered twice during health education teacher training. Teaching was seen as transferring knowledge and skills, supporting the active processing of knowledge, supporting transformation of conceptions, supporting holistic personal growth and building a learning community with the students. The teaching was reflected through five themes: the nature of the knowledge, the source of the knowledge, the teacher's role, the pupil's role and the direction of the interaction. The findings support earlier studies but also bring new perspectives to discussions of teaching conceptions. The study also confirms that, although some conceptions seem to be parallel across different educational settings, other conceptions appear to vary over different contexts. (Contains 1 table.)

The study explored the latent construct underlying the assessment conceptions and practices of Finnish Health Education teachers (n = 165) in the context of curricula, seeking thereby to identify the teachers' assessment profiles. Six underlying factors were found to encompass their assessment conceptions and practices, namely Assessment supporting learning, Assessment of working, Self and peer assessment as part of grading, Common assessment criteria, Questionable assessment practices, and Norm-referenced assessment. Via cluster analysis, three distinct assessment profiles were identified, labeled as Problematic assessors, Learning supportive assessors, and Norm-based assessors. These findings can be used to develop Health Education teacher training and facilitate teachers' assessment literacy. [ABSTRACT FROM AUTHOR]

Background: Health literacy (HL) is an important determinant for maintaining and improving health throughout the lifespan. This underlines the need to monitor HL, including among adolescents, and to understand the factors explaining HL, with a view to decreasing differences in HL. The aim of this study was to objectively measure HL, and the relationship between HL and socio-demographic factors (gender, language of instruction, pupils' educational aspirations, parents' educational background and pupils' school achievement) among pupils (n = 3652) at the end of basic education in Finland. Methods: A nationally representative assessment, which included 55 items on HL, was conducted as a traditional paper-and-pencil test in schools. The data were analysed via descriptive statistics and a two-level hierarchical linear model to determine how the socio-demographic factors affected HL. Results: The pupils' average score on the HL test items was 58.9%, indicating a satisfactory HL level. A two-level hierarchical linear model showed that the variables (gender, language of instruction, pupils' educational aspirations, parents' educational background and pupils' school achievement) predicting the HL level had statistically significant effects. Conclusions: Among ninth graders (15–16 years old), almost one third of the boys and 8% of the girls exhibited an unsatisfactory HL level. The study also confirmed the importance of school-related factors in explaining HL differences. Since low HL has been linked to several unfavourable health indicators and has been viewed as an underestimated problem in times of pandemic and other health crises, the findings suggest that the HL level of Finnish ninth graders is a clear public-health issue. [ABSTRACT FROM AUTHOR]

Background To address social inequalities in adolescent substance use and consequent disparities in health, it is important to identify the mechanisms of the association between substance use and academic performance. We study the role of health literacy (HL) in the association between academic performance and weekly smoking, monthly alcohol use and cannabis ever-use among adolescents in Europe. Methods SILNE-R school survey data, which was collected in 2016–17 with paper-and-pencil-method from Hanover (GE), Amersfoort (NL) and Tampere (FI), were used (N  = 5088, age 13–19). Health Literacy for School-aged Children instrument was used to assess students' HL. Logistic regression analyzed the association of substance use with academic performance and HL, separately and in the same model. Linear and multinomial logistic regression analyzed the association between academic performance and HL. Results Poor academic performance compared with high was associated with smoking [odds ratio (OR) 3.94, 95% confidence interval (CI) 2.83–5.49], alcohol use (OR: 2.94, 95% CI: 2.34–3.68) and cannabis use (OR: 2.56, 95% CI: 1.89–3.48). Poor HL was also associated with each substance use (with ORs of 2.32, 1.85 and 1.29). HL was positively associated with academic performance (β = 1.04, 95% CI: 0.89–1.20). The associations between academic performance and substance use were only slightly attenuated after controlling for HL. Conclusions Academic performance and HL were both determinants of substance use, confirming their role in tackling the disparities in substance use. However, HL did not demonstrably mediate the association between academic performance and substance use. A wider set of factors needs to be tackled to address emerging social inequalities in adolescent substance use. [ABSTRACT FROM AUTHOR]

Background The concept of health literac y (HL) may help us to better understand the mechanisms leading to health disparities, and to focus on the factors that can be influenced. However, not much is yet known about how HL is related to health disparities, or whether the association exists among adolescents. The aim of the study was to examine the associations between structural stratifiers, HL and health indicators among adolescents. Methods The nationally representative Finnish Health Behaviour in School-aged Children survey data (n =3833) were collected from 13- and 15-year-old pupils in the spring of 2014. Pearson correlation coefficients were calculated, and separate path models were estimated for the perceived health and health behaviour measures. Results HL was found to be an independent factor explaining disparities in health. Higher HL was related to positive health outcomes. HL also acted as a mediator between health behaviours and structural stratifiers, except for gender. School achievement and educational aspirations were among the factors explaining the HL level, which in turn, explained the health indicators. Conclusion The concept of HL is of use in understanding health disparities. In particular, HL provides a mechanism via which school achievement and educational plans affect health outcomes. Low HL places adolescents who have poor school achievement and who do not intend to continue on an academic path in an unequal position with respect to their health. [ABSTRACT FROM AUTHOR]

Background Health literacy (HL) is an important determinant of health and health behaviours, and there is a need to monitor HL levels among all population groups. It is therefore essential to develop instruments to assess HL during childhood and adolescence. The aim of this study was to examine the cross-national measurement invariance of the instrument Health Literacy for School-aged Children (HLSAC) in four European countries. Methods The data were collected via standardized self-administered anonymous questionnaires within classrooms in Finland, Poland, Slovakia, and Belgium. There were in total 1468 respondents (aged 13, N = 690; aged 15, N = 778). The HLSAC instrument was used to measure the subjective HL of adolescents in each country. A multigroup confirmatory factor analysis was applied to test measurement invariance. Results Configural and metric invariance was established, but scalar invariance did not hold. However, the instrument exhibited high internal consistency (α = 0.85) and showed adequate fit with the data. Moreover, the partial invariance allowed comparison of mean values across the countries in question. There were significant mean value differences between countries and age-groups. Conclusions HL mean values (as assessed via the HLSAC instrument) can be compared across countries. The instrument has utility for large-scale international HL studies on adolescents. [ABSTRACT FROM AUTHOR]

For the management of the COVID-19 pandemic, risk communication has been a much-needed preventive and educative action to support citizens – including children – to adopt preventive and health protective measures. However, the COVID-19 pandemic is not the only health concern at hand that has raised concerns about the health status of children and required disease-preventive strategies. Bearing in mind the mental health problems and learning losses reported during the pandemic, in this commentary, we will argue that by now, it is time to consider critically if there could be more space for positive communication and education, both alongside and as an integral part of risk communication, to help adolescents not just to survive but also to live the fullest possible life now and in the future. Otherwise, the adolescents of COVID-19 could become 'the children of risk communication' to the detriment of their health and well-being. [ABSTRACT FROM AUTHOR]

Objective: The aim of this research study was to identify the core competencies for health education teachers in supporting the development of health literacy among their students. Method/Results: A three round Delphi method was employed. Experts in health education were asked to identify core competencies for school health educators. Twenty six participants from the academic field were invited to participate in the study. Twenty participants completed the first round of the Delphi, while eighteen took part in round two and fifteen participated in the final round. Data were collected using an electronic questionnaire. The first round contained an open ended question in which participants were asked to name and define all the competencies they perceived were important. Thematic analysis was undertaken on these data. A list of 36 competencies was created from this round. This list was then returned to the same participants and they were asked to rate each competency on a 7 point semantic differential scale in terms of importance. The resulting data were then analysed. For the final round, participants were presented with a list of 33 competencies and were asked to rank them again, in order of importance. Conclusion: Twelve core competencies emerged from the analysis and these competencies comprised of a mixture of knowledge, attitude and skills. The authors suggest that how these competencies are achieved and operationalised in the school context can be quite complex and multi-faceted. While the authors do not seek to generalise from the study they suggest that these competencies are an important input for all stakeholders, in order to question national and international teacher guidelines. In addition the competencies identified may provide a useful starting point for others to undertake deeper analysis of what it means to be an effective health educator in schools. [ABSTRACT FROM AUTHOR]

Only a few countries have introduced health education (HE) as a stand-alone school subject. In Finland every pupil in basic education grades 7-9 takes three obligatory courses in HE. This study investigated Finnish pupils' perceptions of the teaching and learning of HE. It also explored how school- and family-related background variables are associated with these perceptions. Nationally representative data were obtained from a 2010 school-based study on Health Behaviour in School-aged Children (HBSC). A total of 4262 pupils from 7th and 9th grades (13 and 15 years old) responded anonymously to the questionnaire. Logistic regression analysis was performed to identify the associations between perceptions of HE and school- and family-related background variables. The majority of the pupils had positive perceptions of HE. In terms of their own learning, girls' perceptions were more positive than boys': 86% of 13- and 15-year-old girls agreed that HE classes had taught them to think about the advantages and disadvantages of various health behaviours, whereas only 79% of boys shared this opinion. School engagement had the strongest association with perceptions of HE: the more positive the attitudes towards school, the more positive were the perceptions of HE. Older girls perceived their learning and their participation in class discussions more positively than younger ones, and older boys were more critical of the teaching than younger ones. The pupils' educational aspirations were not associated with their perceptions of HE, and perceived family affluence was associated only with girls' perceptions of participation in HE classes. The pupils' feedback on HE was positive and encouraging. There is a demand for the subject in society, and HE seems to have the potential to augment young people's positive attitudes towards health issues, and to enhance their health literacy. [ABSTRACT FROM AUTHOR]

The aim of this phenomenographic study was to identify student teachers' ways of experiencing the teaching of health education, and to determine the aspects that are educationally critical in gaining a deeper understanding of the teaching. Qualitative data (written essays, semi-structured interviews) were gathered twice during health education teacher training. Teaching was seen as transferring knowledge and skills, supporting the active processing of knowledge, supporting transformation of conceptions, supporting holistic personal growth and building a learning community with the students. The teaching was reflected through five themes: the nature of the knowledge, the source of the knowledge, the teacher's role, the pupil's role and the direction of the interaction. The findings support earlier studies but also bring new perspectives to discussions of teaching conceptions. The study also confirms that, although some conceptions seem to be parallel across different educational settings, other conceptions appear to vary over different contexts. [ABSTRACT FROM AUTHOR]