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Mediation and moderation effect of psychosocial factors on the relationship between health literacy and well-being in adolescents

2026-02-12Artigo de investigação Acesso aberto
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dc.contributor.authorGaspar, Tania
dc.contributor.authorCarvalho, Marina
dc.contributor.authorArriaga, Miguel
dc.contributor.authorSousa, Barbara
dc.contributor.authorGaspar-Matos, Margarida
dc.date.accessioned2026-03-23T09:56:50Z
dc.date.available2026-03-23T09:56:50Z
dc.date.issued2026-02-12
dc.description.abstractPurpose: Higher health literacy is associated with better health behaviors and better overall well-being; however, the contribution of relational and socio-economic factors to this association remains insufficiently explored. The present study aimed to examine the relationships between health literacy, well-being, social support, and stress among adolescents. In particular, the mediating roles of social support (family, peers, and teachers) and stress in the association between health literacy and well-being were analyzed. Participants and Methods: Data were drawn from the 2022 wave of the Health Behaviour in School-aged Children (HBSC) study, an international survey conducted every four years in collaboration with the World Health Organization (WHO) and implemented according to a standardized protocol. The sample comprised 7643 students from the 6th, 8th, 10th, and 12th grades of Portuguese public schools. Of the participants, 53.9% were female, and the mean age was 15.05 years (SD = 2.36). Gender-based comparisons indicated statistically significant differences for all study variables, with the exception of health literacy. Results: Mediation analysis reveals an effect of health literacy on well-being. After the inclusion of the mediating variables, the direct effect of health literacy on lack of well-being remained negative. All four mediators showed statistically significant indirect effects, accounting for the difference between the total and direct effects. These findings indicate that the association between health literacy and lack of well-being was partially mediated by family support, peer support, relationships with teachers, and stress. Health literacy influenced lack of well-being both directly and indirectly through these mediating pathways, with stress emerging as the strongest indirect contributor. Conclusions: The findings support an ecological interpretation of health literacy and well-being, as these constructs are embedded within multiple interacting systems. Individual adolescent characteristics, such as gender, age, and stress management, are interconnected with interpersonal contexts, including relationships with family members, peers, and teachers. In addition, adolescents’ socio-economic circumstances appear to play a relevant role in shaping both health literacy and perceptions of well-being.eng
dc.identifier.citationGaspar, T., Carvalho, M., Arriaga, M., & Sousa, B. et al. (2026). Mediation and moderation effect of psychosocial factors on the relationship between health literacy and well-being in adolescents. Pediatric Reports, 18(1), Article 29. https://doi.org/10.3390/pediatric18010029
dc.identifier.doi10.3390/pediatric18010029
dc.identifier.eid105031256385
dc.identifier.issn2036-7503
dc.identifier.other24e39645-4c28-4177-b87b-6c3513419469
dc.identifier.pmcPMC12922089
dc.identifier.pmid41718441
dc.identifier.urihttp://hdl.handle.net/10400.14/57391
dc.identifier.wos001700102000001
dc.language.isoeng
dc.peerreviewedyes
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectFamily
dc.subjectMental health
dc.subjectPublic health
dc.subjectSchool
dc.subjectSocio-economic
dc.subjectYouth
dc.titleMediation and moderation effect of psychosocial factors on the relationship between health literacy and well-being in adolescentseng
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.issue1
oaire.citation.titlePediatric Reports
oaire.citation.volume18
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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