Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK

Marchant, Emily; Lowthian, Emily; James, Michaela; Davies, Nia; Crick, Tom

doi:10.1093/heapro/daaf026

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Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK

Emily Marchant

, Emily Lowthian

, Michaela James

, Nia Davies, Tom Crick

Health Promotion International, Volume: 40, Issue: 2, Start page: daaf026

Swansea University Authors: Emily Marchant , Emily Lowthian , Michaela James , Tom Crick

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DOI (Published version): 10.1093/heapro/daaf026

Abstract

Childhood is a period of significant formative development where knowledge, skills, and capacities for adequate health literacy are acquired, particularly within school settings. The new Curriculum for Wales (CfW), phasing in from September 2022 for learners aged 3–16 years, places statutory focus o...

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Published in:	Health Promotion International
ISSN:	0957-4824 1460-2245
Published:	Oxford University Press (OUP) 2025
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa68934

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last_indexed	2025-08-22T12:26:43Z
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spelling	2025-08-21T13:52:20.5382070 v2 68934 2025-02-20 Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK d68adb6744707b3bd75e07bd334d0516 0000-0002-9701-5991 Emily Marchant Emily Marchant true false db5bc529b8a9dfca2b4a268d14e03479 0000-0001-9362-0046 Emily Lowthian Emily Lowthian true false 9a717d184fb8f768e462d95b91e63e23 0000-0001-7047-0049 Michaela James Michaela James true false 200c66ef0fc55391f736f6e926fb4b99 0000-0001-5196-9389 Tom Crick Tom Crick true false 2025-02-20 SOSS Childhood is a period of significant formative development where knowledge, skills, and capacities for adequate health literacy are acquired, particularly within school settings. The new Curriculum for Wales (CfW), phasing in from September 2022 for learners aged 3–16 years, places statutory focus on health and well-being and school-level curriculum design, providing unprecedented opportunities to empower children as agents in making health-enhancing decisions. Designing, tracking, and evaluating impacts of the CfW on children’s health literacy requires scalable monitoring tools; however, research efforts have focused on adolescent populations. This national-scale scoping and pilot study, the first to explore children’s health literacy in Wales, piloted the Health Literacy for School-Aged Children (HLSAC-5) within the existing nationwide Health and Attainment of Pupils in Primary EducatioN (HAPPEN-Wales) health and well-being survey to examine the health literacy of children aged 8–11 (n = 2607) and explore associations between health literacy and health behaviours. Children’s health literacy was categorized as low (22.6%), moderate (50.4%), and high (27.0%). Multinomial logistic regression analyses suggest high health literacy compared to low health literacy was associated with higher sleep [relative risk ratio (RRR): 1.08, 95% CI 1.01–1.15], higher weekly physical activity (RRR: 1.13, 95% CI 1.03–1.25), fewer sedentary days per week (RRR: 0.89, 95% CI 0.81–0.99), and higher health-related well-being (RRR: 1.35, 95% CI 1.27–1.44). This study offers a sustainable measure of pre-adolescent children’s health literacy and health behaviours and tracking of CfW impacts. This enables efforts to be tailored to person-centred (understanding children’s health literacy needs), place-based (examining specific organizational health literacy context within schools and CfW design), and policy-focused approaches (re-energizing health literacy within current/emerging policies in Wales including the CfW). Journal Article Health Promotion International 40 2 daaf026 Oxford University Press (OUP) 0957-4824 1460-2245 health literacy, health behaviours, schools, education, curriculum, curriculum for wales, health monitoring 10 4 2025 2025-04-10 10.1093/heapro/daaf026 COLLEGE NANME Social Sciences School COLLEGE CODE SOSS Swansea University SU Library paid the OA fee (TA Institutional Deal) This work was supported by Swansea University Faculty of Humanities and Social Sciences Seedcorn Fund 2022/23. 2025-08-21T13:52:20.5382070 2025-02-20T15:03:52.4805667 Faculty of Humanities and Social Sciences School of Social Sciences - Education and Childhood Studies Emily Marchant 0000-0002-9701-5991 1 Emily Lowthian 0000-0001-9362-0046 2 Michaela James 0000-0001-7047-0049 3 Nia Davies 4 Tom Crick 0000-0001-5196-9389 5 68934__34021__2fbfc58ee67f4a45876e604bb96c67e4.pdf 68934.VOR.pdf 2025-04-11T15:21:45.9802382 Output 1290375 application/pdf Version of Record true © The Author(s) 2025. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY). true eng https://creativecommons.org/licenses/by/4.0/
title	Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK
spellingShingle	Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK Emily Marchant Emily Lowthian Michaela James Tom Crick
title_short	Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK
title_full	Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK
title_fullStr	Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK
title_full_unstemmed	Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK
title_sort	Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK
author_id_str_mv	d68adb6744707b3bd75e07bd334d0516 db5bc529b8a9dfca2b4a268d14e03479 9a717d184fb8f768e462d95b91e63e23 200c66ef0fc55391f736f6e926fb4b99
author_id_fullname_str_mv	d68adb6744707b3bd75e07bd334d0516_*_Emily Marchant db5bc529b8a9dfca2b4a268d14e03479__Emily Lowthian 9a717d184fb8f768e462d95b91e63e23__Michaela James 200c66ef0fc55391f736f6e926fb4b99_*_Tom Crick
author	Emily Marchant Emily Lowthian Michaela James Tom Crick
author2	Emily Marchant Emily Lowthian Michaela James Nia Davies Tom Crick
format	Journal article
container_title	Health Promotion International
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publishDate	2025
institution	Swansea University
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publisher	Oxford University Press (OUP)
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description	Childhood is a period of significant formative development where knowledge, skills, and capacities for adequate health literacy are acquired, particularly within school settings. The new Curriculum for Wales (CfW), phasing in from September 2022 for learners aged 3–16 years, places statutory focus on health and well-being and school-level curriculum design, providing unprecedented opportunities to empower children as agents in making health-enhancing decisions. Designing, tracking, and evaluating impacts of the CfW on children’s health literacy requires scalable monitoring tools; however, research efforts have focused on adolescent populations. This national-scale scoping and pilot study, the first to explore children’s health literacy in Wales, piloted the Health Literacy for School-Aged Children (HLSAC-5) within the existing nationwide Health and Attainment of Pupils in Primary EducatioN (HAPPEN-Wales) health and well-being survey to examine the health literacy of children aged 8–11 (n = 2607) and explore associations between health literacy and health behaviours. Children’s health literacy was categorized as low (22.6%), moderate (50.4%), and high (27.0%). Multinomial logistic regression analyses suggest high health literacy compared to low health literacy was associated with higher sleep [relative risk ratio (RRR): 1.08, 95% CI 1.01–1.15], higher weekly physical activity (RRR: 1.13, 95% CI 1.03–1.25), fewer sedentary days per week (RRR: 0.89, 95% CI 0.81–0.99), and higher health-related well-being (RRR: 1.35, 95% CI 1.27–1.44). This study offers a sustainable measure of pre-adolescent children’s health literacy and health behaviours and tracking of CfW impacts. This enables efforts to be tailored to person-centred (understanding children’s health literacy needs), place-based (examining specific organizational health literacy context within schools and CfW design), and policy-focused approaches (re-energizing health literacy within current/emerging policies in Wales including the CfW).
published_date	2025-04-10T05:21:02Z
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Examining the health literacy and health behaviours of children aged 8–11 in Wales, UK

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