HEALTH LITERACY AND ASSOCIATED FACTORS AMONG ADOLESCENTS AND YOUNG ADULTS LIVING IN THE TRAIRI REGION OF THE RIO GRANDE DO NORTE STATE
Pregnancy in adolescence. Health literacy. Women. Prenatal care.
Introduction: Health literacy is the cognitive ability to understand and interpret the meaning of health information in written, spoken and digital form and the individual with the appropriate level of health literacy is able to make appropriate decisions regarding their health in the context of health everyday life. Low health literacy has been associated with risk behaviors, low self-care, higher hospitalization rates and higher costs with health care. Adolescent pregnancy is also related to poorer health outcomes for mother and child compared to adulthood pregnancy and low health literacy may be a contributor to these outcomes. Some studies have assessed the level of sexual and reproductive health literacy of pregnant women, however, as far as we known, there is a lack of studies that have assessed the level of general health literacy among this group, particularly among pregnant adolescents and from low-income settings. Objective: To evaluate health literacy of pregnant adolescents and young adults from rural area of northeastern Brazil and its associated factors. Methods: This is an observational and analytical cross-sectional study, which is part of a longitudinal pilot study, AMOR (Adolescence and Motherhood Research). The sample consisted of 41 pregnant adolescents (13 to 18 years old) and 45 pregnant young adults (23 to 28 years old) living in the Trairi region, located in the Rio Grande do Norte state, during the third trimester of their first pregnancy. Health literacy was assessed by the Short Assesment of Health Literacy for Portuguese-Speaking Adults (SAHLPA, score from 0-18, inadequate if <15). In addition, we collected sociodemographic data, prenatal information and social support though the Social Networks and Social Support of the International Mobility in Aging Study. The Mann Whitney test was used to compare health literacy of adolescents and adults, as well as between the groups of other sociodemographic, social support and prenatal variables. The association between adequate and inadequate literacy and other study variables was assessed by the chi-square test. Linear regression models were used to assess which variables remain associated to the SAHLPA score in the multivariate analyses. Results: Adolescents had worse SAHLPA scores than adults (p <0.001), as well as a higher percentage of inadequate literacy (95.1% versus 53.3%, p <0.001). Poorer health literacy results were also found among those who reported that their school performance was lower when compared to peers (β= 2.843, p <0.001) and reporting insufficient income for basic needs (β= 2.775, p =0.014) in multivariate analysis. Conclusion: Higher rates of inadequate health literacy were found, mainly among adolescent mothers. Policies targeting to improve health information access for young populations from rural low-income areas are needed.