{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:49:44Z","timestamp":1791355784561,"version":"4.3.1"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional descriptive study was conducted among 475 adolescents aged 15\u201318\u202fyears 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The average scores were 30.04\u202f\u00b1\u202f8.53 for social network addiction symptoms, 31.02\u202f\u00b1\u202f4.85 for health literacy, and 70.61\u202f\u00b1\u202f10.69 for health promotion. Health promotion was positively correlated with health literacy (\n r<\/jats:italic>\n \u202f=\u202f0.327,\n p<\/jats:italic>\n \u202f&lt;\u202f0.0001) and negatively correlated with social network addiction symptoms (\n r<\/jats:italic>\n =\u202f\u22120.117,\n p<\/jats:italic>\n \u202f=\u202f0.011). Health literacy was also negatively correlated with social network addiction symptoms (\n r<\/jats:italic>\n \u202f=\u202f\u22120.229,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). A cross-sectional statistical mediation model showed that health promotion was positively associated with health literacy (\n \u03b2<\/jats:italic>\n \u202f=\u202f0.299,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), whereas health literacy significantly associated with lower social network addiction symptoms (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.277,\n p<\/jats:italic>\n \u202f&lt;\u202f0 0.001). While the indirect effect through health literacy was significant [\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.083, BootSE\u202f=\u202f0.019, 95% CI (\u22120.122, \u22120.048)], suggesting a significant indirect association through health literacy, while the direct association was not statistically significant (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.020,\n p<\/jats:italic>\n \u202f=\u202f0.664).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1897518","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:53:11Z","timestamp":1791352391000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Health literacy as an indirect pathway in the association between health promotion behaviors and social network addiction symptoms among adolescents"],"prefix":"10.3389","volume":"14","author":[{"given":"Shaimaa","family":"Mohamed Amin","sequence":"first","affiliation":[{"name":"Department of Community, Psychiatric, and Mental Health Nursing, College of Nursing, Qassim University","place":["Buraydah, Saudi Arabia"]},{"name":"Department of Community Health Nursing, Faculty of Nursing, Damanhour University","place":["Damanhour, Egypt"]},{"name":"Department of Nursing Services, Qassim University Medical City","place":["Buraydah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer A.","family":"Alkubati","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Nursing, College of Nursing, University of Hail","place":["Hail, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halla Ali Abd El Hie","family":"Ali","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Beni-Suef University","place":["Beni-Suef, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud Abdelwahab","family":"Khedr","sequence":"additional","affiliation":[{"name":"Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Alexandria University","place":["Alexandria, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally Mohammed","family":"Farghaly Abdelaliem","sequence":"additional","affiliation":[{"name":"Department of Nursing Administration, Faculty of Nursing, Alexandria University","place":["Alexandria, Egypt"]},{"name":"Department of Nursing, Faculty of Allied Health Sciences, Kuwait University","place":["Kuwait City, Kuwait"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesreen AbdelMonaem","family":"AbouZeid","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman Mohamed","family":"El-Ashry","sequence":"additional","affiliation":[{"name":"Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Alexandria University","place":["Alexandria, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"989","DOI":"10.3390\/children11080989","article-title":"The transition from childhood to adolescence: between health and vulnerability","volume":"11","author":"Mastorci","year":"2024","journal-title":"Children"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"63","DOI":"10.3390\/healthcare12010063","article-title":"Healthy lifestyle in adolescence: associations with stress, self-esteem and the roles of school violence","volume":"12","author":"Gonz\u00e1lez Moreno","year":"2023","journal-title":"Healthcare (Basel)"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1007\/s13668-025-00706-4","article-title":"Adolescent nutrition and health: a critical period for nutritional intervention to prevent long-term health 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