{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:28:26Z","timestamp":1787030906152,"version":"build-2736575974"},"reference-count":116,"publisher":"National Athletic Trainers' Association","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Low health literacy disproportionately affects individuals and communities that are socially disadvantaged or have geographical barriers to health care. For injuries such as concussion, preparticipation education is typically mandatory, but it is unclear if the reading level of these educational documents is suitable to meet the health literacy needs of adolescent athletes across urban and rural communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess differences in health literacy among adolescent athletes in urban and rural communities and compare scores with the state-mandated concussion education handout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>High school athletics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants<\/jats:title>\n                    <jats:p>Participants included 270 adolescent athletes in total who attended urban (n = 157) and rural (n = 110) schools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>The Rapid Estimate of Adolescent Literacy in Medicine-Teen (REALM-Teen) was used to assess a participant\u2019s ability to read common medical words and lay terms for body parts and illnesses. The tool consists of 66 words divided into 3 lists, and scores can range from 0 to 66. Scores are tabulated into a health literacy score for each participant, equating to a grade-specific reading level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Urban adolescent athletes had a higher total REALM-Teen score than rural participants (\n                      <jats:italic>t<\/jats:italic>\n                      = 3.868,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001). Urban adolescents had higher mean scores than those from rural locations for each individual REALM-Teen list; score differences were statistically significant for lists 2 and 3 (\n                      <jats:italic>t<\/jats:italic>\n                      = 2.888,\n                      <jats:italic>p<\/jats:italic>\n                      = .004;\n                      <jats:italic>t<\/jats:italic>\n                      = 4.012,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001, respectively). Only 26% (n = 41) of urban and 12.7% (n = 14) of rural adolescent athletes scored at a reading level that aligns with the health literacy level necessary to read \/comprehend the state-provided concussion education handout.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Urban adolescent athletes had better health literacy compared with their rural peers; however, irrespective of rurality, more than half of participants had low health literacy for their appropriate age\/grade in high school (\u2264seventh grade). Ensuring that health information is provided at an appropriate reading level for the target audience is essential to increasing health literacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-0049.25","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:31:04Z","timestamp":1755045064000},"page":"881-888","source":"Crossref","is-referenced-by-count":1,"title":["Health Literacy Among Adolescent Athletes Across Rural and Urban Communities and Evaluating Scores Aside State-Mandated Concussion Education"],"prefix":"10.4085","volume":"60","author":[{"given":"Jessica","family":"Wallace","sequence":"first","affiliation":[{"name":"Department of Health Science, Athletic Training Program, The University of Alabama, Tuscaloosa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley","family":"Bryant","sequence":"additional","affiliation":[{"name":"Department of Health Science, Athletic Training Program, The University of Alabama, Tuscaloosa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makyra","family":"Ross","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Kentucky, Lexington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danae Delfin","family":"Talley","sequence":"additional","affiliation":[{"name":"School of Physical Therapy and Rehabilitation Sciences, Morsani College of Medicine, University of South Florida Health, Tampa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Leonard","sequence":"additional","affiliation":[{"name":"Department of Health Science, Athletic Training Program, The University of Alabama, Tuscaloosa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Margaret","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Health, Exercise and Sports Science, University of New Mexico, Albuquerque"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Covassin","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Michigan State University, East Lansing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Beidler","sequence":"additional","affiliation":[{"name":"Department of Athletic Training, Duquesne University, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"10","key":"i1938-162X-60-12-881-b01","series-title":"Am J Public Health","first-page":"1682","article-title":"The importance of place of residence: examining health in rural and nonrural areas","volume":"94","author":"Eberhardt","year":"2004","unstructured":"Eberhardt MS,\nPamuk ER. The importance of place of residence: examining health in rural and nonrural areas. Am J Public Health. 2004;94(10):1682\u20131686. doi:10.2105\/ajph.94.10.1682"},{"issue":"2","key":"i1938-162X-60-12-881-b02","series-title":"J Environ Health Sci","first-page":"90","article-title":"Continuing challenges in rural health in the United States","volume":"5","author":"Coughlin","year":"2019","unstructured":"Coughlin SS,\nClary C,\nJohnson JA, et al. Continuing challenges in rural health in the United States. J Environ Health Sci. 2019;5(2):90\u201392."},{"issue":"10","key":"i1938-162X-60-12-881-b03","series-title":"Public Health","first-page":"813","article-title":"Rural-urban disparities in the prevalence of diabetes and coronary heart disease","volume":"126","author":"O\u2019Connor","year":"2012","unstructured":"O\u2019Connor A,\nWellenius G. Rural-urban disparities in the prevalence of diabetes and coronary heart disease. Public Health. 2012;126(10):813\u2013820. doi:10.1016\/j.puhe.2012.05.029"},{"issue":"2","key":"i1938-162X-60-12-881-b04","series-title":"J Rural Health","first-page":"167","article-title":"A closer look at rural-urban health disparities: associations between obesity and rurality vary by geospatial and sociodemographic factors","volume":"33","author":"Cohen","year":"2017","unstructured":"Cohen SA,\nCook SK,\nKelley L,\nFoutz JD,\nSando TA. A closer look at rural-urban health disparities: associations between obesity and rurality vary by geospatial and sociodemographic factors. J Rural Health. 2017;33(2):167\u2013179. doi:10.1111\/jrh.12207"},{"issue":"1","key":"i1938-162X-60-12-881-b05","series-title":"Am J Public Health","first-page":"155","article-title":"Growth and persistence of place-based mortality in the United States: the rural mortality penalty","volume":"109","author":"Cosby","year":"2019","unstructured":"Cosby AG,\nMcDoom-Echebiri MM,\nJames W,\nKhandekar H,\nBrown W,\nHanna HL. Growth and persistence of place-based mortality in the United States: the rural mortality penalty. Am J Public Health. 2019;109(1):155\u2013162. doi:10.2105\/AJPH.2018.304787"},{"issue":"12","key":"i1938-162X-60-12-881-b06","series-title":"Health Aff (Millwood)","first-page":"2003","article-title":"Higher US rural mortality rates linked to socioeconomic status, physician shortages, and lack of health insurance","volume":"38","author":"Gong","year":"2019","unstructured":"Gong G,\nPhillips SG,\nHudson C,\nCurti D,\nPhilips BU. Higher US rural mortality rates linked to socioeconomic status, physician shortages, and lack of health insurance. Health Aff (Millwood). 2019;38(12):2003\u20132010. doi:10.1377\/hlthaff.2019.00722"},{"issue":"3","key":"i1938-162X-60-12-881-b07","series-title":"J Rural Health","first-page":"405","article-title":"Differences in rural and urban health information access and use","volume":"35","author":"Chen","year":"2019","unstructured":"Chen X,\nOrom H,\nHay JL, et al. Differences in rural and urban health information access and use. J Rural Health. 2019;35(3):405\u2013417. doi:10.1111\/jrh.12335"},{"issue":"1","key":"i1938-162X-60-12-881-b08","series-title":"J Rural Health","first-page":"60","article-title":"Rural adolescent health: the importance of prevention services in the rural community","volume":"27","author":"Curtis","year":"2011","unstructured":"Curtis AC,\nWaters CM,\nBrindis C. Rural adolescent health: the importance of prevention services in the rural community. 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BMJ Open. 2018;8(6):e020080. doi:10.1136\/bmjopen-2017-020080"},{"issue":"3","key":"i1938-162X-60-12-881-b11","series-title":"Iran J Public Health","first-page":"448","article-title":"The status of health literacy in students aged 6 to 18 old years: a systematic review study","volume":"50","author":"Jafari","year":"2021","unstructured":"Jafari A,\nTavakoly Sany SB,\nPeyman N. The status of health literacy in students aged 6 to 18 old years: a systematic review study. Iran J Public Health. 2021;50(3):448\u2013458. doi:10.18502\/ijph.v50i3.5584"},{"issue":"2","key":"i1938-162X-60-12-881-b12","series-title":"J Adolesc Young Adult Oncol","first-page":"106","article-title":"Health literacy in adolescents and young adults: an updated review","volume":"5","author":"Sansom-Daly","year":"2016","unstructured":"Sansom-Daly UM,\nLin M,\nRobertson EG, et al. Health literacy in adolescents and young adults: an updated review. 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Patient Educ Couns. 2020;103(10):2142\u20132154. doi:10.1016\/j.pec.2020.06.007"},{"key":"i1938-162X-60-12-881-b28","series-title":"J Adolesc","first-page":"116","article-title":"Adolescent health literacy and health behaviors: a systematic review","volume":"62","author":"Fleary","year":"2018","unstructured":"Fleary SA,\nJoseph P,\nPappagianopoulos JE. Adolescent health literacy and health behaviors: a systematic review. J Adolesc. 2018;62:116\u2013127. doi:10.1016\/j.adolescence.2017.11.010"},{"issue":"6","key":"i1938-162X-60-12-881-b29","series-title":"Pediatrics","first-page":"e1707","article-title":"Development and validation of the Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen): a tool to screen adolescents for below-grade reading in health care settings","volume":"118","author":"Davis","year":"2006","unstructured":"Davis TC,\nWolf MS,\nArnold CL, et al. 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