A Survey of Health Literacy among Secondary School Teachers in the City of Azarshahr, Iran
Journal of Medical Library and Information Science,
Vol. 7 No. 7 (2026),
6 Ordibehesht 2026
https://doi.org/10.22037/jmlis.v7i7.52207
Abstract
Introduction: Beyond empowering teachers to care for their own well-being, health literacy can shape students’ lifestyles and society through role modeling. This study investigated health literacy among public secondary school teachers.
Methods: This cross-sectional survey included all public secondary school teachers (n = 150) in Azarshahr, East Azerbaijan, Iran, through a census. The questionnaire link was sent via the Department of Education, with 136 teachers responding. Data were collected from July 23 to November 30, 2020, using the validated HELIA questionnaire. Data analysis was performed using descriptive and inferential statistics with the help of SPSS and Excel software.
Results: The main sources of health information were the Internet (62.5%), consulting health professionals (22.1%), and radio/television (11.8%). Dimension mean scores were 3.90 for access, 3.99 for reading, 4.23 for understanding, 3.90 for evaluation, and 3.89 for decision-making/behavior, with a total mean of 3.92 (out of 5). Health literacy levels showed 48.53% sufficient, 27.21% excellent, 18.38% not quite sufficient, and 5.88% Insufficient. No significant differences were found by gender or field of study (P > 0.05). Age and work experience showed a significant negative correlation with health literacy (P ≤ 0.05).
Conclusion: Given teachers’ primary reliance on the Internet for health information and their satisfactory level of health literacy, digital platforms offer promising capacity-building opportunities. The absence of significant differences in health literacy of respondents based on gender and field of study supports universal training initiatives, though older and more experienced teachers should be prioritized for health literacy training.
- Health literacy
- Teachers
- Public secondary schools
- Iran
How to Cite
References
1. What you need to know about literacy [Internet]. UNESCO. 2025 [cited 2026 Sep 20]. Available from: https://www.unesco.org/en/literacy/need-know
2. Tavousi M, Haeri Mehrizi, A, Rafiefar S, Solimanian A, Sarbandi F, Ardestani M, et al. Health literacy in Iran: findings from a national study. Payesh [Internet]. 2016 [Cited 2026 Sep 20]; 15(1):95-105. Available from: http://payeshjournal.ir/article-1-199-en.html. [In Persian].
3. Peerson A, Saunders M. Health literacy revisited: What do we mean and why does it matter? Health Promot Int. 2009;24(3):285-296. doi: 10.1093/heapro/dap014
4. Health literacy [Internet]. World Health Organization. 2024 [cited 2026 Sep 20]. Available from: https://www.who.int/news-room/fact-sheets/detail/health-literacy
5. Von Wagner C, Knight K, Steptoe A, Wardle J. Functional health literacy and health-promoting behaviour in a national sample of British adults. J Epidemiol Community Health. 2007;61(12):1086-1090. doi: 10.1136/jech.2006.053967
6. Yeganeh R, Tavakoli S. Improving the health literacy plan for librarians in Astan Quds Razavi libraries: Providing an applied model for assessing Kirkpatrick's effectiveness. Shamseh [Internet]. 2015 [cited 2026 Sep 20]; 7(26-27):1-16. Available from: https://shamseh.aqr-libjournal.ir/article_59510.html. [In Persian].
7. Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. doi: 10.1186/1471-2458-12-80
8. Sudore RL, Mehta KM, Simonsick EM, Harris TB, Newman AB, Satterfield S, et al. Limited literacy in older people and disparities in health and healthcare access. J Am Geriatr Soc. 2006;54(5):770-776. doi: 10.1111/j.1532-5415.2006.00691.x
9. Tehrani Banihashemi SA, Haghdoost AA, Amirkhani MA, Alavian SM, Asgharifard H, Baradaran H, et al. Health literacy and the influencing factors: A study in five provinces of Iran. Strides Dev Med Educ [Internet]. 2007 [cited 2026 Sep 20]; 4(1):1-9. Available from: https://sdme.kmu.ac.ir/article_90113.html. [In Persian].
10. Fouladi N, Hazrati S, Shabani M, Nejaddadgar N. Investigating middle-aged health literacy in Ardabil. J Health Lit [Internet]. 2017 [cited 2026 Sep 20] ;2(1):39-44. Available from: https://literacy.mums.ac.ir/article_10951.html. [In Persian].
11. Ahmadi F, Mehrmohammadi M, Montazeri A, Vella J. Health literacy and teacher education. J New Thoughts Educ. 2018;14(1):7-30. doi: 10.22051/jontoe.2018.13734.1648. [In Persian].
12. Khosravi N, Bakhtiari E, Mostafavian Z. Studying the level of health literacy of teachers in Mashhad city in the academic year 2017-2018 and its influencing factors. 13th Annual Research Congress of Medical Sciences Students in the East of the Country (24 April). [conference proceedings on the Internet]. Birjand University of Medical Sciences, 2019. Birjand. [cited 2026 Sep 20]. Available from: https://en.civilica.com/doc/899296/. [In Persian].
13. Rahimi B, Tavassoli E. Measuring health literacy of elementary school teachers in Shahrekord. J Health Lit. 2019;4(1):25-32. doi: 10.22038/jhl.2019.38770.1039. [In Persian].
14. Bae EJ, Yoon JY. Health literacy as a major contributor to health-promoting behaviors among Korean teachers. Int J Environ Res Public Health. 2021;18(6):3304. doi: 10.3390/ijerph18063304
15. Health literacy in schools: an education asset in the 21st century [Internet]. UNESCO. UNESCO Chair Global Health & Education; 2021 [cited 2026 Sep 20]. Available from: https://unescochair-ghe.org/health-literacy-an-education-asset-in-the-21st-century/
16. Otten C, Nash R, Patterson K. HealthLit4Kids: Teacher experiences of health literacy professional development in an Australian primary school setting. Health Promot Int. 2023;38(3):daac053. doi: 10.1093/heapro/daac053
17. Ghasemi A-H, Kianpour Lirharani R, Saki N, Arezoomand M. The role of health literacy in reducing healthcare costs and referring to the hospital among elderly. J Med Libr Inf Sci. 2021;2(2):1-6. doi: 10.22037/jmlis.v2i.33107
18. lotfi M, sedghi Sh, panahi S. Evaluation of the effect of training on the health literacy, self-care, and HbA1c of type 2 diabetic patients. J Med Libr Inf Sci. 2024;5(5):1-12. doi: 10.22037/jmlis.v5i.44712
19. Varnaseri A, Ghanbari Khoshnood M, Andalib Kondori M, Jasemi A, Akhavanhariri E, Hoseini Ahangari SA. Assessing health literacy levels and information-seeking anxiety in postgraduate students. J Med Libr Inf Sci. 2024;5(5):1-12. doi: 10.22037/jmlis.v5i.46381
20. Ahmadi FZ, Mehrmohammadi M, Talaee E, Fardanesh H, Paknahad M, Taghizadeh S, Hamedi H, Nourozi S, Montazeri A. Health literacy among students of Farhangian University. Payesh [Internet]. 2018 [cited 2026 Sep 20] ;17(3):257-266. Available from: https://payeshjournal.ir/article-1-44-en.html. [In Persian].
21. Jafari Roozbahani N, araghieh A, assareh A, Davaee M, Moghaddasi H. Analyzing teachers' lived experiences of challenges and opportunities of health literacy education in elementary school (a phenomenological study). J New Approaches Educ Adm. 2025;15(5):209-224. doi: 10.30495/jedu.2024.32078.6428. [In Persian].
22. Mirzapour Ermaki R, Mirzaie M, Naghibi Sistani MM. Oral health literacy and health behavior of primary school teachers in Babol. J Health Lit. 2019;3(4):66-74. doi: 10.22038/jhl.2019.38472.1035. [In Persian].
23. Mirzaei S. Investigating the relationship between health literacy level and health information search method with general health of school teachers in Jahrom city in 2016. [Thesis]. Marvdasht, Iran: Marvdasht Islamic Azad University; 2016. [In Persian].
24. Lau SSS, Shum ENY, Man JOT, Cheung ETH, Amoah PA, Leung AYM, et al. Assessing COVID-19-related health literacy and associated factors among school teachers in Hong Kong, China. Front Public Health. 2022;10:1057782. doi: 10.3389/fpubh.2022.1057782
25. Mshingo DM, Muhanga MI, Salanga RJ, Ngowi EE. Determinants of primary school teachers’ health literacy in Morogoro Municipality, Tanzania: A reflection on access to health information. Adv Public Health. 2023;(1):1799988. doi: 10.1155/2023/1799988
26. Montazeri A, Tavousi M, Rakhshani F, Azin SA, Jahangiri K, Ebadi M, et al. Health Literacy for Iranian Adults (HELIA): development and psychometric properties. Payesh [Internet]. 2014;13(5):589-599. [cited 2026 Sep 20]. Available from: http://payeshjournal.ir/article-1-279-en.html. [Persian].
27. Gliem JA, Gliem RR. Calculating, interpreting, and reporting Cronbach’s Alpha reliability coefficient for Likert-type scales [Internet]. Midwest Research-to-Practice Conference in Adult, Continuing, and Community Education; 2003 [cited 2026 Sep 20]. Available from: https://hdl.handle.net/1805/344
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