https://literacy.mums.ac.ir/ Journal of Health Literacy en daily 1 Tue, 21 Oct 2025 00:00:00 +0330 Tue, 21 Oct 2025 00:00:00 +0330 https://literacy.mums.ac.ir/article_26905.html Background and Objective: Diabetes Mellitus (DM) ranks as one of the most common non-contagious diseases and its importance has been widely acknowledged. Nevertheless, health literacy and lifestyle factors have a big impact on how well people control and manage this condition. The current relationship between health-promoting behaviors and health literacy among DM patients of the Military hospital is discussed in this article.Materials and Methods: This cross-sectional investigation encompassed a sample of 281 type 2 DM patients attending the endocrinology clinic at Baqiyatallah Hospital. Data collection was achieved through the employment of a checklist comprising 12 demographic items, a 33-item Health Literacy Instrument for Adults (HELIA) questionnaire, and a 51-item Walker's Health-Promoting Lifestyle Profile (HPLP II) questionnaire. Data analysis was completed by implementing Pearson’s correlation coefficient, independent t-tests, analysis of variance, and hierarchical linear regression, which was done by using SPSS ver. 22.Results: The mean age of the participants was calculated to be 45.2 ± 17.2 years. The participents’ charachteristics mostly consisted of being men (66.9%), married (63.7%), and having a diploma (45.9%). In this study, a moderate positive correlation was found between health literacy and health-promoting behaviors (r=0.405) (p=0.000). Furthermore, people ages 45 and above and those with a non-medical job had the highest scores on health-promoting behaviors, and non-smokers had a higher score on health literacy. Liner Regression analysis demonstrated that reading, access, decision-making, and behavioral intention significantly predicted health-promoting behaviors (R²=0.295, p<0.000),with decision-making showing the strongest effect (β=0.242, p=0.002).Conclusion: The findings of the current study verify that there is a relationship between health literacy and lifestyle, and that edjucational programs focus more on improving specific domains like accessing, reading and decision-making, as identified in the regression for DM patients. https://literacy.mums.ac.ir/article_27076.html Pediatric cardiac surgery involves navigating profound perplexities for caregivers, from understanding intricate pathophysiology to managing long-term care. So, explore these challenges through a health literacy lens, arguing that low health literacy exacerbates inherent difficulties, jeopardizing informed consent and postoperative outcomes. It is concluded that integrating health literacy sensitive communication is not ancillary but fundamental to achieving equitable, high-quality, and family-centered care. https://literacy.mums.ac.ir/article_26888.html Background and Objectives: Oral health disparities remain a major public health challenge in Thailand, particularly in areas with limited dental care access. While village health volunteers (VHVs) are crucial for community health education, their role in promoting oral health through nutrition literacy remains underutilized. This study evaluated a nutrition literacy program's impact on VHVs' oral health knowledge, skills, and practice using mixed-methods research.Materials and Methods: This study was conducted from January to March 2024 in Health Region 1, northern Thailand, using a mixed methods embedded experimental design. Sixty VHVs from mountainous areas with high oral health needs and limited dental access received a three-day training program delivered by dentists and nutritionists. Training covered nutrition literacy, communication skills, and practical community application. Data collection included pre-post tests using a researcher-developed 16-item knowledge assessment (α = 0.78) validated by experts, skill evaluations (6-item checklist, α = 0.85), observations from 5 qualified observers, and focus group discussions. Data analysis included paired t-tests and thematic analysis with methodological triangulation (p < 0.05).Results: Participants (mean age 52.15 ± 7.20 years, 95% female) demonstrated significant knowledge improvement (mean difference = 7.38; p < 0.001) and effectiveness indices of 88.16/88.33, surpassing the 80/80 benchmark. Mean skill scores were 15.67 ± 2.319 out of 18 points. Qualitative results showed increased confidence, teamwork, technology use, leadership skills, and effective community knowledge application.Conclusion: The program effectively enhanced VHVs' oral health knowledge and skills. Recommendations include: (1) incorporating the program into regular VHV training curricula with quarterly assessments, (2) establishing mentorship systems between experienced and new VHVs, (3) developing community-based oral health monitoring systems utilizing VHVs' enhanced skills, and (4) creating local support networks for continuous knowledge exchange and skill reinforcement. These recommendations aim to strengthen community oral health promotion by enhancing VHV capacity. https://literacy.mums.ac.ir/article_27100.html Background and Objective: In today's digital era, the increasing integration of technology into daily life has significantly influenced health behaviors and literacy, particularly among university students in health-related fields such as nursing. The aim of this study is to investigate the relationship between the use of information technologies and smartphone addiction levels with digital healthy diet literacy among nursing students.Material and Methods: This descriptive study was conducted with 368 nursing students between January and May 2023. Data was collected using the Descriptive Information Form, the Information Technology Use Scale, the Smartphone Addiction Scale, and the Digital Healthy Diet Literacy Scale. Results: The mean scores of these scales were 56.25±8.85, 32.14±9.86 and 20.05±10.51 respectively. There was a significant difference in the scores on the Scale of Utilization of Information Technologies by grade level (p<0.05), with a significant difference between second and fourth graders (p=.025). A positive, very weak, significant correlation was found between the Scale of Utilization of Information Technologies and the Digital Healthy Diet Literacy Scale (r=.161, p=.002), and between the Smartphone Addiction Scale and the Digital Healthy Diet Literacy Scale (r=.153, p=.003).  Multiple regression analysis indicated that both information technology use (β =.135, p =.010) and smartphone addiction (β =.126, p=.017) were weak but significant predictors of digital healthy diet literacy, although the overall model accounted for only 3.6% of the variance (F(2, 365) =7.81, p<.001).Conclusion: The study suggests that there are weak but significant relationships between levels of information technology use, smartphone addiction and digital healthy diet literacy that vary by grade level.  https://literacy.mums.ac.ir/article_26835.html Background and Objective: Improving mental health literacy is a major strategy for reducing the burden of mental health disorders. Mental health literacy of postpartum depression is defined as knowledge and beliefs about postpartum depression that help recognize, control, or prevent it. The present study aimed to explore the effect of an educational intervention on improving mental health literacy of postpartum depression in pregnant women in eastern Iran.Material and Methods: The present quasi-experimental study was conducted on pregnant women in Sarayan city. The data collection instrument was a standard mental health literacy questionnaire on postpartum depression. Sixty pregnant women who met the inclusion criteria were selected from healthcare centers, and were randomly divided into an intervention and a control group. The educational intervention was held in six 45-minute educational sessions for the intervention group. The questionnaire was completed before the intervention and one month after childbirth by the intervention and control groups. The data were entered into SPSS18 and analyzed at a significance level of 0.05.Results: Before the intervention, the two groups did not have a statistically significant difference in terms of the mean score of mental health literacy along different dimensions (p>0.05). However, the mean scores of all dimensions of mental health literacy (i.e., Ability to recognize postpartum depression, Knowledge of risk factors and causes, Knowledge and beliefs of self-care activities, Knowledge about professional help available, Beliefs about professional help available, Attitudes which facilitate recognition of postpartum depression and appropriate help-seeking and Knowledge of how to seek information related to postpartum depression) increased significantly in the intervention group one month after childbirth compared to the pretest (p<0.05).Conclusion: Based on results of this study, educational interventions have the potential to improve mental health literacy of postpartum depression. Current evidence is limited by few studies directly measured postpartum depression literacy.  More research is needed to properly assess the effect of health literacy interventions on mental health literacy of pregnant women.  https://literacy.mums.ac.ir/article_26892.html Background and Objective: Middle-aged adults often experience anxiety related to aging, particularly as they face life challenges and health-related concerns associated with getting older. Health literacy is a key factor in managing well-being during this stage of life, especially when dealing with chronic conditions. This study explores the relationship between anxiety about aging and health literacy in middle-aged individuals.Material and Methods: A descriptive correlational study was carried out in 2024, involving 431 middle-aged residents of Babol city. Participants were selected through convenience sampling. Data were gathered using a demographic questionnaire, the Lasher and Faulkender Anxiety about Aging Scale (AAS) with a Cronbach’s alpha coefficient of 0.82, and the Iranian Health Literacy Questionnaire (HELIA) with a Cronbach’s alpha coefficient of 0.94. Statistical analysis was conducted using SPSS version 16, including independent t-tests, ANOVA, regression analysis, and Pearson’s correlation coefficient.Results: The average score for anxiety about aging was 49.50±8.98, indicating a moderate level, while the mean health literacy score was 67.69±13.86, indicating an adequate level of health literacy. Anxiety about aging was significantly associated with gender (P=0.01), occupation (P=0.02), education (P=0.026), marital status (P=0.029), and income (P=0.002). Health literacy was significantly related to age (P=0.002), education (P=0.001), occupation (P=0.002), insurance coverage (P=0.001), income (P<0.001), and sources of health information (P=0.005). A significant inverse relationship was found between anxiety about aging and health literacy (r=-0.425, P<0.001). All dimensions of anxiety about aging were inversely correlated with every domain of health literacy (P<0.001).Conclusion: Enhancing health literacy within middle-aged population could play a pivotal role in reducing anxiety related to aging, as individuals with higher health literacy are better equipped to manage health-related challenges and make informed decisions. It is crucial for policymakers to design and implement educational programs that focus on enhancing health literacy and alleviating anxiety about aging among middle-aged individuals. https://literacy.mums.ac.ir/article_26870.html Background and Objectives: Enhancing women's health literacy leads to a better understanding of health information and can directly influence child nutrition and health throughout the developmental years. This study compared the health literacy of mothers with preterm and full-term births regarding exclusive breastfeeding and related factors among those attending healthcare centers in the Mashhad districts.Materials and Methods: This cross-sectional study was conducted in 2023 on 648 women with children under two years of age who attended health centers in Mashhad, Iran. Participants were selected using proportional random sampling. Data were collected through validated and reliable questionnaires assessing demographic characteristics, the Labbok breastfeeding levels questionnaire to assess breastfeeding status, and maternal health literacy. Data analysis was performed using SPSS version 25, employing the Kolmogorov-Smirnov test, Chi-square test, independent t-test, one-way ANOVA, Mann–Whitney U test, and Kruskal–Wallis test, with a significance level set at p < 0.05.Results:  The mean score of total health literacy as well as its domains of auditory comprehension and self-management among mothers with preterm and full-term deliveries was (39.5 ± 9.6, 27.7± 6.8, 11.7 ± 3.4) and (42.1 ± 8.50, 29.7 ± 6.0, 12.3 ± 2.8), respectively. A statistically significant difference was observed between the two groups in terms of health literacy level and exclusive breastfeeding practices (p < 0.05). In addition, maternal occupation, educational level, economic status, family support, number of pregnancies, residence, and infant growth status were significantly associated with maternal health literacy (p < 0.05).Conclusion: The results indicated that health literacy among mothers of preterm birth was lower than that of mothers with full-term birth, and this group was less likely to practice exclusive breastfeeding. Therefore, developing targeted educational interventions—such as breastfeeding counseling and health literacy training focused on neonatal care—may help improve feeding behaviors and promote the health of preterm birth. https://literacy.mums.ac.ir/article_27082.html Background and Objective: This study aimed to evaluate the reliability and validity of the Persian version of the osteoarthritis short health literacy questionnaire (OSHL) for musculoskeletal patients (LiMP) among individuals with osteoarthritis in Iran.Material and Methods: A cross-sectional validation study was conducted with 420 patients aged 45–75 years, recruited from the rheumatology clinic of Shahid Beheshti Hospital in Hamadan. The LiMP questionnaire underwent a rigorous translation and back-translation process. Psychometric evaluation included assessments of face validity (qualitative interviews and item impact scores), content validity (expert panel review, Content Validity Ratio [CVR], and Content Validity Index [CVI]), and construct validity (exploratory and confirmatory factor analyses). Reliability was examined using Cronbach’s alpha for internal consistency and the intraclass correlation coefficient (ICC) for test-retest stability.Results: The Persian LiMP demonstrated strong face and content validity, with all items achieving impact scores above 1.5, a CVR of 0.86, and a CVI of 0.95. Exploratory factor analysis identified a three-factor structure: Musculoskeletal Conditions, F2: Musculoskeletal Diagnosis and treatment, and F3:Anatomy and terminology; accounting for 71.07% of the variance, confirmed by confirmatory factor analysis with good model fit indices (e.g., the Comparative Fit Index  = 0.962, the root mean square error of approximation = 0.083). All subscales showed high internal consistency (Cronbach’s alpha > 0.70) and satisfactory test-retest reliability (mean the Intraclass correlation coefficient = 0.789). Convergent and discriminant validity were generally supported.Conclusions: The Persian version of the LiMP for musculoskeletal patients is a reliable and valid instrument for assessing health literacy in this population. Its use can facilitate targeted interventions and improve patient outcomes.  https://literacy.mums.ac.ir/article_26840.html Background and Objectives: Health, Safety, and Environment Culture (HSEC) shapes employees’ awareness, attitudes, and behaviors toward occupational risks. Occupational Health and Safety Literacy (OHSL) is a key determinant of accident prevention, well-being, and regulatory compliance. Understanding the HSEC–OHSL relationship is essential for organizational performance and worker safety. Structural Equation Modeling (SEM) offers tools to investigate such relationships; however, researchers face the choice between covariance-based SEM (CB-SEM) and partial least squares SEM (PLS-SEM). By contrasting these approaches, this study contributes to the theoretical understanding of safety culture and literacy and informs methodological decisions in occupational health research.Materials and Methods: We conducted a cross-sectional survey of personnel at Shahid Hasheminejad Gas Refining Company (Khangiran) (n = 410) using cluster sampling. Instruments included demographic checklists and validated HSEC and OHSL questionnaires. Data were analyzed with PLS-SEM (SmartPLS) and CB-SEM (AMOS) to compare approaches in estimating relationships and underlying factor structures. Model fit, factor loadings, (R2), and predictive relevance were evaluated.Results:  Mean scores were 78.66 ± 20.73 for HSEC and 74.67 ± 12.94 for OHSL (0–100 scale). Both SEM approaches showed a significant positive association: (rPLS=0.68) and (rCB=0.70). In PLS-SEM, factor loadings were higher than in CB-SEM. Based on loadings and (R2), the most influential OHSL facet was the use of health and safety information; for HSEC, on-the-job training and human factors were prominent. In CB-SEM, the communications factor had the highest loading.Conclusion: Our findings support a positive HSEC–OHSL interrelationship, contributing to workplace safety and organizational performance. Overall, high levels of HSEC and OHSL suggest a foundation for promoting safe practices and continuous safety-management improvement. Enhancing both culture and literacy may yield synergistic effects for a safer, more productive work environment. https://literacy.mums.ac.ir/article_27085.html Background and Objective: E-health literacy involves the ability to search for, find, estimate and evaluate information about health and/or health services. Online sources of health information are now a privileged way of accessing information, especially among students. The aim of this study was to access the level of e- health literacy in a sample of Portuguese university students; and to relate the level of e-health literacy with sociodemographic characteristics; analyze differences between health and non-health students and with the use of online health information. Material and Methods: An observational cross-sectional study was conducted on Portuguese university students. All students completed a questionnaire consisting of social-demographic characteristics, and sources of health online information used. The digital health literacy score was assessed by the eHEALS scale validated for the Portuguese population. Descriptive and inferential analysis was applied, as well as multivariate regression models. Results: In this study, 534 university students participated; the median age was 21.0. The level of e-health literacy was 28.8 (5.6). Health-sciences students had higher digital health literacy scores than students from other fields. Most students considered the internet to be useful and very useful in making health decisions. Students' use of health online information sources such as official health websites (OR= 2.6; CI 95%= 1.5;4.3) and professional health websites (OR= 2.3; CI95%= 1.4; 3.8) increased their likelihood of having a sufficient level of e-health literacy. While the use of information sources such as social networks (OR= 0.5; 95%CI: 0.3;0.9) decreases the likelihood of having a sufficient level of e-health literacy.Conclusion: Health students showed higher levels of health literacy, demonstrating the importance of including health education in the curricula of other areas. As a practical implication, there is a need to include health education, health campaigns, and the promotion of healthy lifestyles in curricula in order to increase health literacy in university. https://literacy.mums.ac.ir/article_27020.html Background and Objectives: Digital health technology should be an educational tool for child care and empowerment when applied to children’s health literacy. This study aimed to analyze digital health technologies that utilize storytelling resources to promote children’s health literacy. Materials and Methods: This integrative review was conducted in six distinct stages across major healthcare databases (MEDLINE/PubMed, CINAHL, Web of Science, and Scopus), selecting studies published between January and February 2023, guided by the research question. The search and selection process for articles was adapted from the Preferred Reporting for Systematic Reviews and Meta-Analyses guidelines. Selected articles were assessed for methodological rigor using a tool adapted from the Critical Appraisal Skills Programme, and Rayaan software was used for data screening. Two independent reviewers were involved in article selection, extraction, and analysis. Results: Of the 13,049 articles identified, 15 studies were selected, focusing on self-care in health management, children’s feelings, and learning through storytelling. Digital health technologies included mobile applications, educational software, virtual reality, videos, and images, which used resources such as storytelling, animation, gamification, comics, storyboards, poetry, music, and interactive narration. Seven studies were identified regarding self-care and health management.Conclusion: Digital health technologies with storytelling, when based on learning and promoting health literacy, can be important tools for expanding children’s experiences of self-care in health management, both inside and outside hospital settings. Therefore, further studies on this topic are needed, encompassing children, parents, teachers, healthcare professionals, institutions, and public policies from the perspective of child health literacy. https://literacy.mums.ac.ir/article_27168.html Background and Objective: Maternal health literacy (MHL) is a woman’s ability to access, understand, interpret and use health information to make informed decisions during pregnancy, childbirth, and the postpartum period that benefit both mother and child. It is a critical determinant of maternal and neonatal health outcomes. However, evidence on maternal health literacy and its determinants in Ethiopia remains scarce and fragmented. Hence, mapping existing evidence can inform policymakers and health practitioners, providing a foundation for designing targeted interventions to improve maternal and neonatal health outcomes. To map existing evidence on maternal health literacy and determinant factors among pregnant women in Ethiopia.Materials and Methods: This scoping review was developed in accordance with the Arksey and O’Malley (2005) framework and the PRISMA-ScR guidelines. Relevant studies were retrieved from peer-reviewed journals, theses, and institutional reports. Data were extracted for study characteristics, measurement tools, maternal health literacy levels, and determinants. Findings were synthesized descriptively and thematically.Results: in this scoping review, the proportion of adequate maternal health literacy levels was ranged from 25.5% to 55.5%. Three broad themes of determinants were developed: socio-demographic (Socio-demographic factors such as educational attainment, age at first pregnancy, residence, and travel time), health service related (Having antenatal and postnatal care, as well as exposure to counseling during facility-based deliveries), and community or structural factors (Enrollment in Community Based Health Insurance (CBHI) and the presence and accessibility of Health Extension Workers (HEWs) were equally important). Conclusion: Maternal health literacy among Ethiopian women remains low and influenced by a combination of socio-demographic, health service related, and community or structural factors. Enhancing MHL requires comprehensive, context-sensitive strategies that improve education, increase access to maternal health services, and strengthen community-based programs. Addressing these multidimensional determinants will empower women to make informed health decisions, ultimately contributing to better maternal and child health outcomes across Ethiopia. https://literacy.mums.ac.ir/article_26868.html Background and Objective: Depression literacy refers to knowledge and beliefs that facilitate the recognition, management, and prevention of depression, and traditional versus digital media are key channels through which mental health information is accessed. The study examined relationships between depression literacy and media consumption patterns among undergraduate students in Moscow universities.Materials and Methods: In May 2022, a cross-sectional online survey of 420 undergraduate students at Moscow universities was conducted using convenience and snowball sampling. Depression literacy was assessed with a researcher-developed instrument grounded in the Mental Health Literacy framework and ICD-11 criteria. Kendall’s tau correlations were computed in RStudio with significance set at p<0.05.Results: Students demonstrated moderate depression literacy, with higher consumption of television and radio associated with greater literacy and higher use of social networks and messaging apps associated with lower literacy.Conclusion: Differential associations between traditional and digital media consumption and depression literacy suggest tailoring mental health interventions to specific media channels and student populations. https://literacy.mums.ac.ir/article_27405.html Background and Objective: Adolescents represent a crucial population for HIV/AIDS prevention, yet their literacy and engagement with digital health resources remain inadequate. Purpose: This study aimed to examine the influence of chatbot literacy, trust in artificial intelligence, and HIV/AIDS sensitivity on HIV/AIDS literacy among late adolescents. Material and Methods: A cross-sectional survey was conducted in August 2025 involving 926 students from senior and vocational high schools, recruited through stratified random sampling. Data were obtained via a validated questionnaire assessing HIV/AIDS literacy, chatbot literacy, AI trust, AI openness, chatbot choice, and HIV/AIDS sensitivity. The digital survey was distributed using QR codes. Descriptive statistics summarized characteristics; Chi-square tests identified associations; logistic regression determined independent predictors (odds ratios, 95% confidence intervals). Ethical clearance and informed consent/assent were secured. Results: HIV/AIDS literacy differed significantly by age, gender, school type, and internet access (p < 0.05). Bivariate analysis showed that chatbot literacy, AI trust, and HIV/AIDS sensitivity were significantly associated with HIV/AIDS literacy (p < 0.001). Multivariate analysis confirmed that AI trust (p < 0.001), chatbot literacy (p = 0.032), and HIV/AIDS sensitivity (p<0.001) remained significant independent predictors. Conclusion: HIV/AIDS literacy among adolescents is shaped by digital competence, AI trust, and health awareness. Strengthening these aspects may enhance youth engagement with health information and support preventive behaviors. https://literacy.mums.ac.ir/article_27040.html Background and Objectives: We are increasingly encountering parental doubts, hesitancy, or even refusal regarding vaccination. Health literacy is a key component that can contribute to reducing parental vaccine hesitancy. However, some studies suggest a more complex, and even counterintuitive, relationship between health literacy and vaccination attitudes. The aim of this study was to examine the predictive role of parental health literacy in shaping negative attitudes toward vaccination.Material and Methods: The research was conducted as a correlational study between April and May 2025 using an online questionnaire. All kindergartens in Serbia were contacted via email. A representative sample consisted of 379 parents of children aged 1 to 7 years.Results: Parents of preschool children in the Republic of Serbia demonstrated low levels of health literacy. Health literacy was found to be a predictor of the following criteria: Mistrust of vaccine benefits [F(1,377)=11.85; p<.01], Worries about unforeseen future effects [F(1,377)=17.57; p<.01], Concerns about commercial profiteering [F(1,377)=29.10; p<.01], Preference for natural immunity [F(1,377)=7.16; p<.01], and Overall negative attitude towards vaccination [F(1,377)=24.38; p < .01], explaining 2–8% of the variance. It was found that a higher level of parental health literacy contributed to a more negative attitude towards childhood vaccination.Conclusion: The findings suggest that a higher level of health literacy does not necessarily correspond to more positive vaccination attitudes. This highlights the importance of considering additional factors such as institutional trust and exposure to misinformation. Future interventions should focus on improving health literacy, developing critical thinking and information appraisal skills. https://literacy.mums.ac.ir/article_27412.html Background and Objectives: Cases of early marriage and sexual violence remain prevalent in Indonesia, highlighting the urgent need for adolescents to possess adequate sexual and reproductive health literacy (SRHL). Junior high school students should have too to prevent risky sexual behaviors, such as premarital or casual sex. However, limited research has examined Indonesian adolescents’ perspectives and understanding of SRHL, and factors influencing the literacy levels. This study aimed to investigate the level of SRHL among junior high school students in Surakarta and to analyze the factors that influence it.Material and Methods: An ex post facto survey was conducted in 2023 involving 447 students aged 13–15 years from eight schools representing the diversity of Indonesia’s school system (public, private, Islamic, and Catholic). Schools were purposively selected to ensure proportional representation, and students were randomly chosen. Data were collected through an online questionnaire consisting: demographic information, a 51-item knowledge test, and a 47-item attitude scale. Instrument validity and reliability were confirmed through expert judgment and field testing. Eta correlation was applied for nominal variables (age, gender, and school type), while Pearson’s correlation was used to analyze relationships between interval variables (knowledge and attitude). SRHL levels were categorized as inadequate, problematic, sufficient, or excellent.Results: Of the total participants, 53.2% demonstrated a sufficient level of SRHL, 19.7% were excellent, 25.5% problematic, and 1.6% inadequate. Weak correlations were found between SRHL and both age (η² = 0.201) and school type (η² = 0.349), while gender showed no significant relationship (η² = 0.099). Knowledge and attitude showed strong positive correlations with SRHL (R = 0.524 and R = 1.000, respectively).Conclusion: Most junior high school students in Surakarta demonstrated sufficient SRHL. Knowledge and attitude were found to be strongly and positively associated with sexual and reproductive health literacy levels. https://literacy.mums.ac.ir/article_27538.html Background and Objectives: ADHD is a chronic neurodevelopmental disorder affecting attention, activity levels, and impulse control, with a global prevalence of about 5% in children. In Iran, rates are similar, with the combined subtype being most common. ADHD impacts children's emotional and social development and places strain on families. Parental health literacy is essential for managing symptoms and improving outcomes; however, research on this topic especially among parents of preschool-aged children in Iran is limited. This study assessed the health literacy of parents whose preschool-aged children were diagnosed with attention-deficit/hyperactivity disorder (ADHD) and examined its association with ADHD in their children during 2022 in Sanandaj. Materials and Methods: This descriptive-analytical study assessed parental health literacy using the “Health Literacy of Parents of Preschool Children” questionnaire, a researcher-developed instrument. Demographic information (including age, gender, education level, and employment status) was collected using a demographic questionnaire reviewed and approved by subject-matter experts. All parents of children diagnosed with ADHD were included through census sampling. Data were analyzed in Stata v.14 using independent t-tests and one-way ANOVA; non-parametric equivalents (Mann–Whitney U and Kruskal–Wallis tests) were applied when normality assumptions were unmet. A significance level of p < 0.05 was considered. Results: Among participants, 67.3% were female and 32.7% male, with a mean age of 34.94 ± 5.07 years. The overall mean parental health literacy score was 19.53 ± 4.07. Nutrition subscale scores were significantly higher among parents of boys (p < 0.05). Having a childcare book at home was significantly associated with both the developmental subscale and total literacy score (p < 0.05). Parental education level showed significant relationships with nutrition, development, and numeracy subscales, as well as total literacy score (p < 0.05). All subscales except development, along with total literacy score, were significantly associated with parental occupation (p < 0.05). Conclusion: Higher socioeconomic status and parental education were linked to increased health literacy. Owning childcare books and seeking accurate health information reflected greater parental responsibility and literacy. https://literacy.mums.ac.ir/article_27084.html Background and Objective: Diabetes mellitus is a global health challenge, and inadequate health literacy contributes to poor self-care, suboptimal glycemic control, and higher complication risks. Accurate measurement of health literacy is vital, yet the psychometric quality of existing tools for diabetes remains uncertain. To identify instruments with the strongest psychometric support to guide future research and clinical practice among patients with diabetes mellitus. Material and Methods: A systematic review was conducted in PubMed, Scopus, ScienceDirect, ProQuest, and Wiley Online Library from inception to September 2025. Eligible studies involved the development, translation, or validation of health literacy instruments in diabetes populations. Psychometric quality was assessed using the COSMIN checklist.Results: Twelve studies describing 10 instruments were included, most of which were diabetes-specific. Internal consistency and construct validity were the most frequently evaluated properties, whereas measurement error, responsiveness, and test–retest reliability were seldom examined. The Diabetes Health Literacy Scale showed the strongest evidence, covering functional, communicative, and critical domains. Other instruments, such as the Functional, Communicative and critical Health literacy; Chinese Health Literacy scale for Diabetes; Korean Health Literacy scale for Diabetes Mellitus; and Health literacy related to adherence to drug treatment, demonstrated moderate evidence but lacked full validation. Domain-specific measures, including the Food Literacy Questionnaire and Oral Health Literacy tool, had limited psychometric support.Conclusion: Ten instruments are available for assessing health literacy in diabetes, yet none has undergone comprehensive psychometric evaluation. The Diabetes Health Literacy Scale appears most suitable for practice and research, though further studies are needed to confirm its structural validity and adaptability across cultures. Continued instrument development and validation are essential for accurate measurement in diverse populations. https://literacy.mums.ac.ir/article_27214.html Background and Objectives: With the proliferation of media platforms as primary sources of health information, evaluating individuals' ability to effectively use these resources is crucial. This study aimed to develop and validate a reliable and valid assessment tool for measuring HRML.Materials and Methods: The study was conducted in 2023, which involved two phases: tool development and validation. An initial draft of the HRML assessment tool was created, encompassing items assessing four key skill domains: Search and Acquire, Understanding, Appraisal, and Applying. Face and content validity were assessed through expert review by 13 health professionals familiar with health and media literacy. Exploratory factor analysis (EFA) was used to examine the interrelationships among the four dimensions and establish item-domain relationships. Confirmatory factor analysis (CFA) evaluated model fit. Reliability was assessed by administering the questionnaire to 203 healthcare service users in Boyer-Ahmad County, and internal consistency was determined using Cronbach's alpha.  Results: The final questionnaire comprised 28 items across four domains of skills: searching and acquiring, understanding, appraising, and applying. The average content validity ratio (CVR) was 0.889, and the average content validity index (CVI) was 0.991. All four HRML dimensions showed significant positive correlations (p < 0.01). CFA indicated acceptable model fit (CMIN/DF = 1.43, AGFI = 0.830, RMSEA = 0.040, CFI = 0.903, IFI = 0.905). Cronbach's alpha for the overall scale was 0.820.Conclusion: Effective health communication is crucial for the success of health interventions. This validated HRML assessment tool can identify areas for improvement in individuals' media literacy skills and determine preferred media sources. This information can inform the development of targeted interventions to promote informed health decision-making in individuals and communities. The tool is suitable for use in various settings, including educational institutions, workplaces, service centers, and community spaces. https://literacy.mums.ac.ir/article_27091.html Background and Objective: Given the importance of quality of sexual life in individual satisfaction and family health, this study aimed to investigate the relationship between sexual health literacy, sexual self-care, and the quality of sexual life among married women in Zahedan in 2024.Material and Methods: This cross-sectional study was conducted on 460 women who were selected by multi-stage sampling method. Valid and reliable instruments were used to collect data, including the standard questionnaires of sexual health literacy (SHELA), sexual self-care and Simond sexual quality of life. Data were analyzed using chi-square tests, one-way analysis of variance, independent t-test and bivariate correlation in SPSS 22 software. Predictors were also determined using hierarchical linear regression analysis.Results: The mean age was 33±7.2 years. Education, occupation, number of children, and marriage age were significantly associated with SHL and self-care (p=0.001). Hierarchical regression showed demographic factors explained 53% of SQoL variance. Adding SHL increased variance to 60% (ΔR²=0.07), and including self-care brought the total to 82% (ΔR²=0.22). Key predictors were promoting sexual health (β=0.13), cancer prevention (β=0.11), and analysis skills (β=0.10).Conclusion: The findings of this study emphasize the importance of promoting sexual health literacy and sexual self-care education in improving the quality of sexual life of women. It is suggested that educational programs and health interventions in this field be designed and implemented to help improve women's sexual health and quality of life. https://literacy.mums.ac.ir/article_27323.html Background and Objective: Assessing women’s literacy about breast cancer is essential to identify existing knowledge gaps and design effective interventions. To translate, culturally adapt, and psychometrically evaluate the Breast Cancer Literacy Assessment Tool (B-CLAT) for use among Iranian women.Materials and Methods: This methodological study was conducted in 2024–2025 among 400 women attending comprehensive health service centers in Tehran, Iran, selected through multistage sampling, to translate and validate the B-CLAT, originally developed in the U.S. The translation process followed the standard forward–backward method by two independent translators in each phase. Face validity was assessed by 10 women, and content validity by 10 experts, according to standard methodological practice. content validity ratio and content validity index were calculated. Construct validity was examined using confirmatory factor analysis and the known-groups method, comparing literacy scores by age and education. Reliability was determined through internal consistency (Cronbach’s alpha) and stability (Intra-class Correlation Coefficient) in a sample of 30 participants. Data were analyzed using SPSS 16 and EQS 6.4 software.Results: Most participants were aged 30–39 years (46%), married (82.5%), and had a university degree (69.3%). The cultural adaptation of the Persian version showed satisfactory equivalence. The overall CVI was 0.942, indicating strong content validity. CFA confirmed acceptable model fit indices (RMSEA=0.063, IFI=0.913, CFI=0.903, GFI=0.919, CMIN/DF=2.956, MFI=0.933, AGFI=0.900). Known-groups comparison showed no significant relationship between literacy scores and age (P>0.05), but a significant association with education level (P<0.05), confirming construct validity. Reliability analysis indicated acceptable stability (ICC=0.868) and internal consistency (α=0.722).Conclusion: The Persian version of the Breast Cancer Literacy Assessment Tool (IB-CLAT) demonstrated good validity and reliability. It can effectively assess breast cancer literacy among Iranian women, guide educational interventions, and promote screening and prevention behaviors. https://literacy.mums.ac.ir/article_27693.html Background and Objectives: When we think of health as a system, mental health is an inseparable part of it, and mental well-being is integrated with it. Mental health literacy and mental well-being are important due to the increasing prevalence of mental illnesses. This study adopts a correlational design to investigate the interplay between mental health literacy and mental well-being. The primary objective is to determine the extent and direction of the relationship between these variables while accounting for demographic differences across two distinct districts of Istanbul.Materials and Methods: This cross-sectional study includes 448 participants. Data were collected using a socio-demographic data form, a mental health literacy scale, and a mental well-being scale. They were analysed using descriptive, correlation, and difference analyses in IBM SPSS 25.Results: No significant difference in mental health literacy levels was found across the general population. However, the mental well-being of individuals residing in Adalar district was significantly higher than that of those living in Esenyurt district. Furthermore, certain demographic factors influenced mental health literacy. A positive correlation was observed between mental well-being and mental health literacy (r=0.181, p<0.01). Conclusion: The findings indicate that enhancing mental health literacy could be a strategic pathway to improving overall mental well-being in urban populations. The results suggest that sociodemographic factors play a significant role in shaping individuals' mental health literacy and well-being in Istanbul. These findings underscore the importance of targeted interventions to address disparities in mental health literacy and well-being.