DOI: https://doi.org/10.14710/nmjn.v15i1.66904

Health Asset Profile and Health Literacy Among Elementary School-Aged Children

*Nunung Siti Sukaesih orcid scopus  -  Nursing Department, Universitas Pendidikan Indonesia, Indonesia
Popi Sopiah orcid  -  Nursing Department, Universitas Pendidikan Indonesia, Indonesia
Emi Lindayani orcid  -  Nursing Department, Universitas Pendidikan Indonesia, Indonesia
Hikmat Pramajati orcid  -  Nursing Department, Universitas Pendidikan Indonesia, Indonesia
Dedah Ningrum orcid  -  Nursing Department, Universitas Pendidikan Indonesia, Indonesia
Sri Wulan Lindasari orcid  -  Nursing Department, Universitas Pendidikan Indonesia, Indonesia
Open Access Copyright (c) 2025 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Accidents, violent behavior, mental health issues, drug misuse, and smoking are among the most serious health problems affecting school-aged children, and they are closely linked to their health behaviors. These behaviors are significantly influenced by literacy skills at this age, yet they often do not receive sufficient attention from the government for this age group.

Purpose: The purpose of this study was to provide a comprehensive overview of health literacy in elementary school-aged children.

Methods: This cross-sectional study used various research instruments, including the Family Affluence Scale (FAS III), Rosenberg Self-Esteem Scale (RSES), Health Behaviors in School-Aged Children (HBSC), European Health Literacy Scale (HLS-EU), and the Newest Vital Sign (NVS). Data were self-reported by participants, along with BMI measurements. A cluster sampling approach was used to recruit 431 sixth-grade students from the Sumedang district. The Chi-square test was employed for statistical analysis.

Results: The research findings showed variation in values across the assessed sub-categories. Correlation analysis between functional health literacy and the health asset profile sub-variables revealed significant relationships with self-esteem (p < 0.001), student behavior (p = 0.010), waking habits (p < 0.001), and smoking habits (p < 0.001). However, functional health literacy was not significantly associated with family affluence (p = 0.868), BMI (p = 0.809), physical activity (p = 0.087), or sleeping habits (p = 0.092).

Conclusion: The study found significant gender disparities in health-related variables, including self-esteem, nutritional status, physical activity, waking habits, and smoking behaviors, suggesting that gender may influence health literacy and related behaviors among elementary school-aged children.

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Keywords: Adolescent; elementary school; health asset profile; health literacy; school-age
Funding: Universitas Pendidikan Indonesia

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  1. Bambra, C., Gibson, M., Sowden, A., Wright, K., Whitehead, M., & Petticrew, M. (2010). Tackling the wider social determinants of health and health inequalities: Evidence from systematic reviews. In Journal of Epidemiology and Community Health (Vol. 64, Issue 4, pp. 284–291). https://doi.org/10.1136/jech.2008.082743
  2. Berg, M., Lindegaard, T., Flygare, A., Sjöbrink, J., Hagvall, L., Palmebäck, S., Klemetz, H., Ludvigsson, M., & Andersson, G. (2022). Internet-based CBT for adolescents with low self-esteem: a pilot randomized controlled trial. Cognitive Behaviour Therapy, 51(5), 388–407. https://doi.org/10.1080/16506073.2022.2060856
  3. Chaput, J. P., Willumsen, J., Bull, F., Chou, R., Ekelund, U., Firth, J., Jago, R., Ortega, F. B., & Katzmarzyk, P. T. (2020). 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5–17 years: summary of the evidence. International Journal of Behavioral Nutrition and Physical Activity, 17(1). https://doi.org/10.1186/s12966-020-01037-z
  4. Chu-Ko, F., Chong, M. L., Chung, C. J., Chang, C. C., Liu, H. Y., & Huang, L. C. (2021). Exploring the factors related to adolescent health literacy, health-promoting lifestyle profile, and health status. BMC Public Health, 21(1), 1–12. https://doi.org/10.1186/s12889-021-12239-w
  5. Corell, M., Chen, Y., Friberg, P., Petzold, M., & Löfstedt, P. (2021). Does the family affluence scale reflect actual parental earned income, level of education and occupational status? A validation study using register data in Sweden. BMC Public Health, 21(1), 1–11. https://doi.org/10.1186/s12889-021-11968-2
  6. Delbosq, S., Velasco, V., Vercesi, C., & Vecchio, L. P. (2022). Adolescents’ Nutrition: The Role of Health Literacy, Family and Socio-Demographic Variables. International Journal of Environmental Research and Public Health, 19(23). https://doi.org/10.3390/ijerph192315719
  7. Dresp-Langley, B., & Hutt, A. (2022). Digital addiction and sleep. International Journal of Environmental Research and Public Health, 19(11). https://doi.org/10.3390/ijerph19116910
  8. Duong, T. V, Aringazina, A., Baisunova, G., Nurjanah, Pham, T. V, Pham, K. M., Truong, T. Q., Nguyen, K. T., Oo, W. M., Mohamad, E., Su, T. T., Huang, H.-L., Sørensen, K., Pelikan, J. M., Van den Broucke, S., & Chang, P. W. (2017). Measuring health literacy in Asia: Validation of the HLS-EU-Q47 survey tool in six Asian countries. Journal of Epidemiology, 27(2), 80–86. https://doi.org/https://doi.org/10.1016/j.je.2016.09.005
  9. Dutil, C., Podinic, I., Sadler, C. M., Da Costa, B. G., Janssen, I., Ross-White, A., Saunders, T. J., Tomasone, J. R., & Chaput, J. P. (2022). Sleep timing and health indicators in children and adolescents: A systematic review. Health Promotion and Chronic Disease Prevention in Canada, 42(4), 150–169. https://doi.org/10.24095/hpcdp.42.4.04
  10. Guo, S., Yu, X., Davis, E., Armstrong, R., & Naccarella, L. (2022). Comparison of Health Literacy Assessment Tools among Beijing School-Aged Children. Children, 9(8), 1–22. https://doi.org/10.3390/children9081128
  11. Jafari, A., Belin, S., Sany, T., & Peyman, N. (2021). The status of health literacy in students aged 6 to 18 old years: A systematic review study. Iran J Public Health, 50(3), 448–458. https://doi.org/https://doi.org/10.18502%2Fijph.v50i3.5584
  12. Kementerian Komunikasi dan Informasi. (2022, July 2). Bank Dunia Naikkan Peringkat Indonesia Jadi ‘Upper Middle Income Country. https://www.kominfo.go.id/content/detail/27568/bank-dunia-naikkan-peringkat-indonesia-jadi-upper-middle-income-country/0/berita
  13. Knisel, E., Rupprich, H., Wunram, A., Bremer, M., & Desaive, C. (2020). Promotion of elementary school students’ health literacy. International Journal of Environmental Research and Public Health, 17(24), 1–13. https://doi.org/10.3390/ijerph17249560
  14. Kohoutek, J., Maráček, M., Ng, K., & Hamrik, Z. (2022). Test–retest reliability of selected HBSC items in Vietnam: well-being, physical and sedentary activities, and eating behaviours. BMC Medical Research Methodology, 22(1). https://doi.org/10.1186/s12874-022-01624-7
  15. Linnebur, L. A., & Linnebur, S. A. (2018). Self-Administered Assessment of Health Literacy in Adolescents Using the Newest Vital Sign. Health Promotion Practice, 19(1), 119–124. https://doi.org/10.1177/1524839916677729
  16. Liu, Y., Wang, M., Villberg, J., Torsheim, T., Tynjälä, J., Lv, Y., & Kannas, L. (2012). Reliability and Validity of Family Affluence Scale (FAS) among Adolescents in Beijing, China. Child Indicators Research, 5, 235–251. https://doi.org/10.1007/s12187-011-9131-5
  17. Loer, A. K. M., Domanska, O. M., Stock, C., & Jordan, S. (2022). Correction: Loer et al. Subjective Generic Health Literacy and Its Associated Factors among Adolescents: Results of a Population-Based Online Survey in Germany (Int. J. Environ. Res. Public Health 2020, 17, 8682). International Journal of Environmental Research and Public Health, 19(3). https://doi.org/10.3390/ijerph19031848
  18. Mao, Y., Xie, T., & Zhang, N. (2020). Chinese students’ health literacy level and its associated factors: A meta‐analysis. International Journal of Environmental Research and Public Health, 18(1), 1–20. https://doi.org/10.3390/ijerph18010204
  19. Muslih, M., & Chung, M.-H. (2024). Structural validity of the Rosenberg self-esteem scale in patients with schizophrenia in Indonesia. Plos One, 5(19), 1–16. https://doi.org/https://doi.org/10.1371/journal.pone.0300184
  20. Ngo, H., VanderLaan, D. P., & Aitken, M. (2020). Self-esteem, symptom severity, and treatment response in adolescents with internalizing problems. Journal of Affective Disorders, 273(January), 183–191. https://doi.org/10.1016/j.jad.2020.04.045
  21. Nugraha, K. W. D., & Seviana, T. (2024). Profil Kesehatan Indonesia 2022. https://kemkes.go.id/id/profil-kesehatan-indonesia-2023
  22. Nutbeam, D. (2015). Defining, measuring and improving health literacy. Health Evaluation and Promotion, 42(4), 16–22. https://doi.org/https://doi.org/10.7143/jhep.42.450
  23. Paakkari, L., Torppa, M., Välimaa, R., Villberg, J., Ojala, K., & Tynjälä, J. (2019). Health asset profiles and health indicators among 13- and 15-year-old adolescents. International Journal of Public Health, 64(9), 1301–1311. https://doi.org/10.1007/s00038-019-01280-7
  24. Palenzuela-Luis, N., Duarte-Clíments, G., Gómez-Salgado, J., Rodríguez-Gómez, J. Á., & Sánchez-Gómez, M. B. (2022). International Comparison of Self-Concept, Self-Perception and Lifestyle in Adolescents: A Systematic Review. International Journal of Public Health, 67. https://doi.org/10.3389/ijph.2022.1604954
  25. Parandeh Afshar, P., Keshavarz, F., Salehi, M., Fakhri Moghadam, R., Khajoui, E., Nazari, F., & Dehghan, M. (2020). Health Literacy and Media Literacy: Is There Any Relation? International Quarterly of Community Health Education. https://doi.org/10.1177/0272684X20972642
  26. Parizadeh, D., Momenan, A. A., Amouzegar, A., Azizi, F., & Hadaegh, F. (2018). Tobacco smoking: Findings from 20 years of the Tehran Lipid and Glucose Study. International Journal of Endocrinology and Metabolism, 16. https://doi.org/10.5812/ijem.84738
  27. Park, A., Eckert, T. L., Zaso, M. J., Scott-Sheldon, L. A. J., Vanable, P. A., Carey, K. B., Ewart, C. K., & Carey, M. P. (2017). Associations between health literacy and health behaviors among urban high school students. Journal of School Health, 87(12), 885–893. https://doi.org/10.1111/josh.12567
  28. Prihanto, J. B. (2021). Health literacy and health behavior: Associated factors in Surabaya high school students, Indonesia. International Journal of Environmental Research and Public Health, 18(15). https://doi.org/10.3390/ijerph18158111
  29. Roy, B., Alison, B., Sarity, D., Suvajee, G., Melanie, H., Linda, K., Richard, O., Dodson, S., Good, S., & Osborne, R. (2015). Optimizing Health Literacy: Improving Health and Reducing Health Inequities A selection of information sheets from The Health Literacy Toolkit for Low-and Middle-Income Countries Contents. http://www.searo.who.int/entity/healthpromotion/documents/hl_advocacy_doc/en/http://www.searo.who.int/entity/healthpromotion/documents/hl_advocacy_doc/en/
  30. Sarhan, M. B. A., Fujiya, R., Kiriya, J., Htay, Z. W., Nakajima, K., Fuse, R., Wakabayashi, N., & Jimba, M. (2023). Health literacy among adolescents and young adults in the Eastern Mediterranean region: a scoping review. BMJ Open, 13(6), e072787. https://doi.org/10.1136/bmjopen-2023-072787
  31. Sopamena, Y., Pongtambing, Y. S., Andriani, W. O. A. S., Fitriani, Y., & Anshari, D. (2022). Adaptasi Alat Ukur Literasi Gizi Pada Mahasiswa Angkatan Pertama Program Sarjana Di Universitas Pattimura, Maluku. Jurnal Gizi Masyarakat Indonesia (The Journal of Indonesian Community Nutrition), 9(2), 83–92. https://doi.org/10.30597/jgmi.v9i2.18946
  32. Sørensen, K., Van Den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., & Brand, H. (2012). Health literacy and public health: A systematic review and integration of definitions and models. In BMC Public Health (Vol. 12, Issue 1). https://doi.org/10.1186/1471-2458-12-80
  33. Suni, E., & Singh, abinav. (2023, September 8). How much sleep do you need? How Sleep Works. https://www.sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need
  34. Tavousi, M., Mohammadi, S., Sadighi, J., Zarei, F., Kermani, R. M., Rostami, R., & Montazeri, A. (2022). Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021. In PLoS ONE (Vol. 17, Issue 7 July). https://doi.org/10.1371/journal.pone.0271524
  35. Van Bortel, T., Wickramasinghe, N. D., Morgan, A., & Martin, S. (2019). Health assets in a global context: A systematic review of the literature. In BMJ Open (Vol. 9, Issue 2). BMJ Publishing Group. https://doi.org/10.1136/bmjopen-2018-023810
  36. van Sluijs, E. M. F., Ekelund, U., Crochemore-Silva, I., Guthold, R., Ha, A., Lubans, D., Oyeyemi, A. L., Ding, D., & Katzmarzyk, P. T. (2021). Physical activity behaviours in adolescence: current evidence and opportunities for intervention. The Lancet, 398(10298), 429–442. https://doi.org/10.1016/S0140-6736(21)01259-9
  37. Vasli, P., Shekarian-Asl, Z., Zarmehrparirouy, M., & Hosseini, M. (2022). The predictors of COVID-19 preventive health behaviors among adolescents: the role of health belief model and health literacy. Journal of Public Health (Germany), Abdoli 2020. https://doi.org/10.1007/s10389-022-01808-x
  38. Vereecken, Carine. A., & Maes, L. (2003). A Belgian study on the reliability and relative validity of the Health Behaviour in School-Aged Children food-frequency questionnaire. Public Health Nutrition, 6(6), 581–588. https://doi.org/10.1079/PHN2003466https://doi.org/10.1079/PHN2003466PublishedonlinebyCambridgeUniversityPress
  39. WHO. (2019). Accelerated Action for the Health of Adolescents (AA-HA!) A manual to facilitate the process of developing national adolescent health strategies and plans. icence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo
  40. WHO. (2022, August 10). Adolescent and young adult health. WHO. https://www.who.int/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions
  41. WHO. (2023, July 31). Tobacco. Fact Sheet. https://www.who.int/news-room/fact-sheets/detail/tobacco
  42. World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. https://www.who.int/publications/i/item/9789240015128
  43. World Health Organization. (2023). Regional consultation on parent support for early childhood development and adolescent health in South-East Asia. https://apps.who.int/iris/bitstream/handle/10665/367021/SEA-CAH-44-eng.pdf?sequence=1&isAllowed=y
  44. Zhang, L., Zhang, D., Fang, J., Wan, Y., Tao, F., & Sun, Y. (2020). Assessment of Mental Health of Chinese Primary School Students Before and After School Closing and Opening During the COVID-19 Pandemic. JAMA Network Open, 3(9), e2021482. https://doi.org/10.1001/jamanetworkopen.2020.21482

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