Adolescent Health Literacy in Hungary: A Cross-National Perspective Using the HELMA-H Instrument

Articles in Press

Document Type : Original Article

Authors

1 Eszterházy Károly Catholic University, Institute of Sport Sciences, Eger, Hungary

2 Hungarian University of Sports Science, Budapest, Hungary

Abstract

Background and Objective: Health literacy refers to the ability to access, understand, and apply health-related information to make informed health decisions. It is a critical determinant of individual and public health. This study aimed to assess the health literacy of Hungarian adolescents using the HELMA-H, the Hungarian adaptation of the Health Literacy Measure for Adolescents (HELMA), and to explore its associations with sociodemographic factors. Findings were also compared with results from similar studies conducted in Asia.

Materials and Methods: The cross-sectional study involved 747 students aged 16–19 (66.8% female) from high schools in Eger, Northern Hungary. Data were collected between January and February 2022 through an anonymous, self-administered online survey. The Questionnaire included demographic questions and the validated HELMA-H instrument (Cronbach’s α = 0.96). Due to non-normal data distribution, nonparametric tests (Mann–Whitney U and Kruskal–Wallis) were used. Statistical analysis was conducted using SPSS 25, with significance set at α = 0.05.

Results: The mean HELMA score was 73.92 ± 16.66, indicating an "adequate" level of health literacy – higher than scores reported in comparable Asian studies. Maternal education was significantly associated with adolescents’ health literacy, and paternal education also had a notable effect. No gender differences were observed, but 12th-grade students scored significantly higher than 11th graders.

Conclusion: The study confirms the validity of the HELMA-H tool in a European context and highlights cultural and regional influences on adolescent health literacy. It underlines the importance of addressing sociodemographic factors – especially parental education – in the design of targeted health education programs to improve adolescent health literacy in Hungary.
 
Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

Keywords

Acknowledgements: The authors would like to express their sincere gratitude to all high school students who participated in this research. Their honest contributions and responses made it possible to apply the HELMA-H tool in Hungary for the first time and provided a foundation for comparative analysis between European and Asian results.
Their involvement supports a deeper understanding of adolescent health literacy and contributes to the development of future educational interventions aimed at promoting health-conscious behaviors.


Availability of Data and Materials: The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.


Conflicts of interest: The authors declare that they have no competing interests. 


Consent for publication: Not applicable.


Ethics Approval and Consent to Participate: This study was conducted in accordance with the Declaration of Helsinki; The study was conducted with the approval of the Research Ethics Committee of Eszterházy Károly Catholic University in Eger, Hungary. Prior to data collection, all participants received detailed information about the purpose, procedure, and data management of the research. Students participated voluntarily and anonymously, with the informed consent of their parents or legal guardians, as well as the approval of their respective schools. Before completing the questionnaire, students were provided with an informed consent form, which clearly stated that their participation was voluntary, could be withdrawn at any time without justification, and that their responses would be treated confidentially and used solely for research purposes. All data were processed confidentially and fully anonymized in accordance with data protection regulations.


Funding: No financial support was received for this study. 


Authors’ Contributions: C. H.: Validation, data collection, data curation, methodology, statistical analysis, original draft writing. T. Cs.: Conceptualization, methodology, statistical analysis, manuscript review and editing.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Journal of Health Literacy

Articles in Press, Accepted Manuscript
Available Online from 28 September 2025

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