Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.11889/8341
Title: Health literacy as a key to improving weight status among Palestinian adolescents living in chronic conflict conditions: a cross-sectional study
Authors: Sarhan, Mohammed B. A. 
Fujiya, Rika 
Shibanuma, Akira 
Giacaman, Rita 
Kiriya, Junko 
Kitamura, Akiko 
Jimba, Masamine 
Keywords: Body mass index - Palestine;Teenagers - Health and hygiene - Weight loss - Palestine;Palestine - Politics and government - Health aspects
Issue Date: 2022
Publisher: BMJ open
Abstract: Objective To examine the moderating role of health literacy in the association between direct exposure to violence and weight status among Palestinian adolescents. Design A household cross-sectional study conducted in 2017. Setting A Palestinian district of the West Bank. Participants Palestinian adolescents aged 11–16 years. Results After excluding underweight adolescents from the 1200 who were initially recruited, the data of 1173 adolescents were analysed. A high proportion (62%) of adolescents were directly exposed to violence. The prevalence of obesity and overweight was 6.5% and 17.1%, respectively. The odds of obesity and overweight were 2.8 and 1.8 times higher among adolescents who were not exposed to domestic and school violence when they had low health literacy in the communication subscale. The odds of obesity were 62% and 57% lower among adolescents with high functional health literacy when exposed to domestic and school violence and to any form of violence, respectively. Among adolescents who were not exposed to any form of violence, those who had high health literacy in the communication subscale were 72% less likely to be obese compared with those who had low health literacy. Conclusions Health literacy moderated the association between direct exposure to violence and weight status. When health literacy levels were higher, lower obesity rates were observed among adolescents who were directly exposed to any form of violence or exposed either to political violence only or domestic and school violence only. The results warrant further investigation of the role of health literacy in adolescent health. It is recommended that policy-makers integrate the health literacy concept into both education and health systems.
URI: http://hdl.handle.net/20.500.11889/8341
DOI: 10.1136/bmjopen-2022-061169
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