Health literacy, alcohol expectancies, and alcohol use behaviors in teens.

OBJECTIVE Alcohol expectancies are developed, in part, through exposure to health messages, the understanding of which may be influenced by health literacy. This study explores the relationships among health literacy, alcohol expectancies, and alcohol use behaviors in teens. METHODS We studied alcohol use behaviors in the past six months in youths aged 14-19 recruited from two adolescent medicine clinics. We assessed covariate-adjusted bivariate relationships between HL, expectancies, and four measures of alcohol use and tested health literacy as a moderator of the relationship between expectancies and use. RESULTS Of the 293 study teens, 45 percent reported use of alcohol in the past six months. Use behaviors were positively associated with higher health literacy and positive expectancies. Our moderation model suggested that health literacy moderates the relationship between expectancies and use, with the expectancy/use relationship being significantly stronger in higher literacy teens. CONCLUSION Findings suggest that health literacy can influence alcohol expectancies and behaviors. PRACTICE IMPLICATIONS Health literacy should be explicitly considered in the design of alcohol prevention messages.