Document Type : Original Article


1 Department of Administrative Sciences, Faculty of Shariati, Tehran Branch, Technical and Vocational University

2 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences

3 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran


BACKGROUND: Health‑promoting behaviors are essential beliefs and actions to develop and
sustain the adolescent health; however, people with inadequate health literacy have poorer health
status. This study aimed to determine the effect of a problem‑based learning (PBL) health literacy
program on improving health‑promoting behaviors among female students (15–18 years) at high
schools in 2018–2019.
METHODS: This study was a quasi‑experimental intervention one which carried out on 377 girl
students using a cluster sampling method of intervention (n = 183) and control (n = 194) groups. The
intervention was performed in four educational sessions of PBL health literacy program using related
scenarios for 90 min. Data were collected through demographic variables, the Health Literacy Measure
for Adolescents, and the Health‑Promoting Lifestyle Profile II. Participants filled the questionnaires
immediately and 3 months after the intervention in both the groups.
RESULTS: There were significant differences comparing the mean score of health literacy
dimensions in numeracy (P < 0.001), use (P < 0.001), communication (P < 0.001), access (P = 0.03),
self‑efficacy (P < 0.001), and total health literacy (P < 0.001) after intervention. These differences
also observed in numeracy (P < 0.001), use (P = 0.03) and total health literacy (P < 0.001) in
follow‑up between the intervention and control groups. The mean scores of health‑promoting lifestyle
dimensions in all dimensions immediately after intervention (P < 0.001) and follow‑up (P ≤ 0.006)
showed significant differences between the two groups, while the intervention group revealed a
higher mean scores.
CONCLUSION: It seems that PBL health literacy and practicing real‑life scenarios can improve
the adolescent lifestyle. It is recommended to examine the effectiveness of the program for other
health‑related behaviors among other populations.


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