Purpose: Health literacy is important for health outcomes in adults. However, little is known about the health literacy of adolescents and young adults (AYAs). The purpose of this study was to provide an updated systematic review examining health literacy among AYAs with and without chronic illness. Specifically, the review considered (1) what sources of health information AYAs use; (2) how well AYAs are able to understand, communicate, and critically evaluate health-related information; and (3) whether health literacy is associated with health behaviors and outcomes.
Methods: A systematic search was conducted for literature published in peer-reviewed journals using Medline, Embase, and PsycINFO databases.
Results: Of 603 articles reviewed, 14 studies met the inclusion criteria, six of which examined health literacy in a chronic illness population. Studies reported high usage for information sources, though no clear links between source type and health literacy emerged. Adequate health literacy was reported in at least 60% of participants, though poor functional literacy was reported. Few studies explored communicative or critical health literacy; those that did indicated that AYAs experience challenges in these domains. Poorer health literacy was associated with some adverse health outcomes, such as obesity and smoking. For AYAs with a chronic illness, there were mixed findings between health literacy and medication adherence.
Conclusion: Understanding the challenges AYAs face with regards to complex developing communicative and critical health literacy skills is crucial. Due to the paucity of research in this field, addressing health literacy across all AYAs will provide a valuable step in guiding research in AYAs with cancer.
Keywords: adolescent; chronic illness; communication; health literacy; young adult.