Relationship between health literacy and physical literacy in adolescent girls: the mediating role of self-efficacy

Introduction: For adolescents to adopt healthy and sustainable lifestyle behaviors, having access to information is not enough; the skills required to translate that information into action are also crucial. This study aimed to investigate the mediating role of self-efficacy in the relationship between health literacy and physical literacy among adolescent girls.
Material and Methods: This was a descriptive, cross-sectional study utilizing structural equation modeling. The sample consisted of 540 female female junior high school students in cities in Mazandaran Province in the year 2025, selected via multi-stage random cluster sampling. Data collection tools included questionnaires assessing demographics, socioeconomic status, perceived physical literacy (Sum et al., 2016), health literacy (Osborne et al., 2013), and general self-efficacy (Sherer & Maddux, 1982). Data analysis involved Pearson correlation coefficients and structural equation modeling using SPSS 25 and PLS 3 software (p < 0.05).
Results: Body Mass Index is inversely correlated with health literacy (r = -0.350; P < 0.01) and physical literacy (r = -0.251; P < 0.01). A significant relationship was found between health literacy and physical literacy among the adolescent girls (p < 0.05; r = 0.486). Self-efficacy mediated the relationship between health literacy and physical literacy (p < 0.05; β = 0.234).
Conclusion: In comprehensive health promotion approaches, the link between health literacy and physical literacy can help bridge the gap between health knowledge and actual behaviors, providing a suitable framework for designing programs aimed at fostering a lifelong, sustainable relationship with physical activity.