Health literacy as an indirect pathway in the association between health promotion behaviors and social network addiction symptoms among adolescents.

BACKGROUND

Although health-promoting behaviors and health literacy may be protective factors against Social network addiction symptoms, little is known about the mechanisms underlying these interactions. This study aimed to investigate the relationship between health promotion and social network addiction symptoms among adolescents and to examine the mediating role of health literacy in this relationship.

METHODS

A cross-sectional descriptive study was conducted among 475 adolescents aged 15-18 years recruited from four secondary schools in Beni-Suef Governorate, Egypt, using a multistage random sampling technique. A demographic questionnaire, the Short-Form Adolescent Health Promotion Scale (SF-AHPS), the Health Literacy for School-Aged Children (HLSAC) scale, and the Social Network Addiction Scale (SNAS) were used to gather data between February and April of 2026.

RESULTS

The average scores were 30.04 ± 8.53 for social network addiction symptoms, 31.02 ± 4.85 for health literacy, and 70.61 ± 10.69 for health promotion. Health promotion was positively correlated with health literacy (r = 0.327, p < 0.0001) and negatively correlated with social network addiction symptoms (r = -0.117, p = 0.011). Health literacy was also negatively correlated with social network addiction symptoms (r = -0.229, p < 0.001). A cross-sectional statistical mediation model showed that health promotion was positively associated with health literacy (β = 0.299, p < 0.001), whereas health literacy significantly associated with lower social network addiction symptoms (β = -0.277, p < 0 0.001). While the indirect effect through health literacy was significant [β = -0.083, BootSE = 0.019, 95% CI (-0.122, -0.048)], suggesting a significant indirect association through health literacy, while the direct association was not statistically significant (β = -0.020, p = 0.664).

CONCLUSION

Health literacy showed a significant indirect statistical association between health promotion and social network addiction symptoms among adolescents. Adolescents with higher health-promoting behaviors demonstrated better health literacy, which in turn was associated with lower levels of social network addiction symptoms.