Health literacy information is crucial for impactful health interventions for adolescents. However, the majority of health literacy measurement tools were originally developed for adults and may not be reflective of adolescent experiences or engaging for an adolescent audience. The present study sought to co-design a health literacy questionnaire with accompanying vignettes for adolescents in Ireland aged 12–18 years.

In 2019–2021, eight adolescents from the Irish Heart Foundation’s Youth Advisory Panel participated in two concept mapping workshops during which they defined healthy living. Results of the thematic analysis indicated that adolescents defined ‘healthy living’ as a life that was balanced, prioritizing mental health and sleep. According to their definition, healthy living was comprised of six main themes, namely, knowledge; sources of quality health information; facilitators and barriers; influence of others; self-efficacy, self-management and resilience; as well as citizenship and communication. 

These themes were used to develop vignettes and items for the Adolescent Health Literacy Questionnaire (AHLQ). These were tested on a sample of 80 adolescents to check whether the respondents understood the items and vignettes as intended. Results of the nine cognitive interviews indicated that the adolescents understood the content of the 10 vignettes and 41 items. While the vignettes and AHLQ were developed with Irish adolescents, the approaches taken can be generalized to adolescents living in other countries. This will allow for the development of tailored and relevant solutions for health literacy development and health promotion for this sub-population.