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<p>Both lifestyle and health literacy are critical determinants of health trajectories with lifelong implications. However, their roles in child health have been less extensively studied compared to adult health. As a reflection of lifestyle, time use is as modifiable as health literacy. If associated with health-related quality of life (HRQoL), addressing suboptimal behavioral and health literacy patterns through targeted interventions could enhance health outcomes across the lifespan. This study, based on a student-based cross-sectional survey conducted in 2018 in Nanjing, China, investigates the compositional time use among primary and secondary school students and examines how variations in time-use patterns and health literacy contribute to differences in HRQoL. Three distinct time-use clusters were identified: Studious actives (highest schooling &amp; domestic work and homework time; 73.38%), Moderate actives (engaged highest in sleep and moderately in most activities; 20.19%), and Techno-actives (highest physical activity time; 6.43%). Compared with Studious actives, the Child Health Utility 9D (CHU9D) utilities were significantly higher for the less study-centered actives, i.e., Moderate actives (mean difference: 0.055; 95%CI: 0.035 to 0.075) and Techno-actives (mean difference: 0.060; 95%CI: 0.022, 0.097). Health literacy was also significant and positively associated with CHU9D utilities. The findings indicate that both time-use patterns and health literacy independently and interactively influence CHU9D utilities. Adolescents with less study-dominant activities and higher health literacy achieved the highest utility scores. These results offer valuable insights for parents and educators in developing optimal time-use strategies and highlight the importance of integrating health literacy into daily practices to improve HRQoL among adolescents.</p>

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The Combined Effects of Time Use Patterns and Health Literacy on Health-related Quality of Life in Children and Adolescents

  • 期刊论文

  • 发表日期：

    2025年7月17日

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  • Yangling Ren,
  • Tianrui Deng,
  • Huiqing Xu,
  • Huifen Qiao,
  • Fei Xu,
  • Gang Chen

摘要

Both lifestyle and health literacy are critical determinants of health trajectories with lifelong implications. However, their roles in child health have been less extensively studied compared to adult health. As a reflection of lifestyle, time use is as modifiable as health literacy. If associated with health-related quality of life (HRQoL), addressing suboptimal behavioral and health literacy patterns through targeted interventions could enhance health outcomes across the lifespan. This study, based on a student-based cross-sectional survey conducted in 2018 in Nanjing, China, investigates the compositional time use among primary and secondary school students and examines how variations in time-use patterns and health literacy contribute to differences in HRQoL. Three distinct time-use clusters were identified: Studious actives (highest schooling & domestic work and homework time; 73.38%), Moderate actives (engaged highest in sleep and moderately in most activities; 20.19%), and Techno-actives (highest physical activity time; 6.43%). Compared with Studious actives, the Child Health Utility 9D (CHU9D) utilities were significantly higher for the less study-centered actives, i.e., Moderate actives (mean difference: 0.055; 95%CI: 0.035 to 0.075) and Techno-actives (mean difference: 0.060; 95%CI: 0.022, 0.097). Health literacy was also significant and positively associated with CHU9D utilities. The findings indicate that both time-use patterns and health literacy independently and interactively influence CHU9D utilities. Adolescents with less study-dominant activities and higher health literacy achieved the highest utility scores. These results offer valuable insights for parents and educators in developing optimal time-use strategies and highlight the importance of integrating health literacy into daily practices to improve HRQoL among adolescents.