Background: With the widespread use of the internet, children have been exposed to health-related information provided in multiple modes, such as text, numerical and video formats from various sources. It is imperative that children develop health literacy in order to make their own medical and health decisions based on reliable information that is appropriate for them. However, the level of health literacy among adults in Japan is lower than in eight EU countries and six other Asian countries. Acquiring health literacy at an early age is an urgent issue.

Objective: Through a thorough literature review, the present study examined the feasibility of employing a comprehensive health literacy scale for children in Japan and overseas.

Methods: A literature search was conducted on PubMed, PsycINFO and CiNii Articles for health literacy scales that targeted participants aged under 20 years. Each item on the available scales was classified in accordance with the 14 components of health literacy for children and youth, which Bröder et al. (2017) identified, as well as the eight components of health education content of the Curriculum Guidelines of the Japanese Ministry of Education, Culture, Sports, Science and Technology for defining the basic standards for education.

Results: In total, 21 scales were found, including 17 from outside Japan. Four of the questionnaires were unavailable, thus leaving 17 scales for examination. All 17 scales were developed between 2000 and 2020, and reliability was confirmed for 13. Among 17 scales, all four health literacy skills (accessing, understanding, appraising and applying) were included with eight. Several scales included child-specific components, such as communication and self-efficacy. Regarding health education content, health promotion was included in all 17 scales; the use of medical facilities, mental health, environment, and health was incorporated in several scales. Most of the scales were self-administered and involved questions about subjective experiences; however, some scales employed objective measures, such as of health knowledge and BMI.

Conclusion: Numerous scales have been developed in Japan and overseas; the assessment methods and components of health literacy and health education content differed among them. In Japan, the HLS-Child-Q15 for elementary school students aged 9 years and above and the MOHLAA-Q for junior and senior high school students aged 14 years and above are notable. With other scales, it is necessary to make a selection based on differences in the components of health literacy and health education content.

Background: Physical fitness in elementary school children may decline due to a decrease in exercise opportunities effectuated by school closures and restrictions on the use of playgrounds, which were intended to prevent the spread of COVID-19. However, few studies have clarified the actual condition of the physical fitness of children who have experienced school closures and restrictions on the use of playgrounds after the onset of the COVID-19 pandemic by comparing the results of the physical fitness tests of children conducted before and after the onset of the pandemic.

Objective: This study aimed to determine the difference in physical fitness in elementary school children who did (the school closures and playground use restrictions group) and did not (the control group) experience school closures and playground use restrictions during the COVID-19 pandemic.

Methods: Overall, 50 and 38 fifth-grade elementary school children were selected for the school closures and playground use restrictions group and the control group, respectively. Physical fitness tests were conducted for the former group while in the third grade (pre) in June 2019 and in the fifth grade (post) in June 2021, and in (pre) June 2017 and in (post) June 2019 for the latter group. For the measurement items, we performed a variance analysis of the groups (the school closures and playground use restrictions group and the control group)×the time (pre and post) by genders.

Results: The results showed that the interaction of the 20m shuttle run for boys was significant(F(1, 86) = 8.95, p＜.01). The simple main effect test demonstrated no significant difference in the results between the school closure and playground use restrictions group (M = 41.0, SD = 13.9) and the control group (M = 46.6, SD = 17.2) during the pre phase. However, in the post phase, the results for the school closure and playground use restriction group (M = 40.7, SD = 15.7) were significantly lower (p＜.01) than those of the control group (M = 57.0, SD = 19.9). Additionally, although the results in the post phase (M = 57.0, SD = 19.9) were significantly higher (p＜.001) than in the pre phase (M = 46.6, SD = 17.2) for the control group, there was no significant difference in the pre (M = 41.0, SD = 13.9) and post (M = 40.7, SD = 15.7) phases in the school closures and playground use restrictions group.

Conclusion: This study revealed that the aerobic capacity of boys who experienced the school closures and playground use restrictions after the COVID-19 pandemic was significantly lower than the result of boys who did not experienced the school closures and playground use restrictions.