Author(s): BAUMANN, H., LABOTT, B., BÜCHEL, D., SCINICARELLI, G., BIALLAS, B., WILKE, C., WOLLESEN, B., Institution: GERMAN SPORT UNIVERSITY COLOGNE, Country: GERMANY, Abstract-ID: 2049

Introduction: Adolescent athletes negotiate a demanding dual pathway: rapid physical and psychosocial development alongside high-stakes pressures of competitive sport. Limited health literacy (HL) in this population may contribute to poor dietary choices, suboptimal injury management, mental health stigma, and unsafe supplement use, underscoring the need for HL. Although several interventions have been implemented in youth elite sport, their content has rarely been examined using a multidimensional HL framework (e.g. Sørensen, 2012). To date, no comprehensive review has synthesized HL intervention evidence across health domains in the group of adolescent athletes. Therefore, this scoping review aimed to (i) provide an overview of existing HL interventions, (ii) map HL intervention types and outcomes to a multidimensional HL model and (iii) summarize reported effectiveness and study quality.
Methods: A preregistered scoping review (PROSPERO ID: CRD420251117528) was conducted in accordance with PRISMA guidance. We included peer-reviewed intervention evaluations targeting HL, health knowledge, or health competence in competitive/high-performance athletes aged approximately 10–19 years. Study, intervention, and outcome characteristics were charted descriptively, and methodological quality was assessed using the Downs and Black checklist (1998). For framework mapping, intervention content and assessed outcomes were deductively coded to various domains (e.g. individual and system level) of the Sørensen et al. (2012) HL-model and aggregated using Gaussian kernel density estimation.
Results: Of 1,268 records identified, 17 studies were included in the qualitative synthesis (total N = 2,724; mean age 16.0 ± 3.1 years; 38.1 ± 37.5% female). Designs were primarily (cluster-) randomized trials (n = 9) and pre–post studies (n = 8). Interventions most frequently addressed nutrition (n = 6), substance-related topics (n = 4), concussion education (n = 3), and mental health (n = 3). Ten studies reported effect estimates; however, reporting quality was low and none used established, validated HL questionnaires. Improvements were reported for knowledge and attitudes, whereas intervention effects on behavioral outcomes were inconsistent. Longer, multi-session programmes indicated stronger improvements than single-exposure interventions. Framework mapping identified the highest coverage in individual-level competencies within the domains of health promotion, behavior, and participation with limited coverage of environmental determinants and system-level outcomes.
Conclusion: HL promotion in adolescent elite sport currently emphasizes proximal, individual-level knowledge and behaviors rather than comprehensive HL concepts. Future interventions should adopt more holistic HL designs that explicitly address contextual determinants, participation, and equity, and should evaluate downstream health and system outcomes using validated HL measures to support durable impact.