Co‑designing a youth health literacy programme for equity and NCD prevention in the Basque Country

Background

Non‑communicable diseases require early, equitable prevention, as young people, at a critical stage for lifelong behaviours, face barriers to accessing, understanding, and using health information and services.

Methods

Within the EU Joint Action JACARDI and based on the WHO Health Literacy Development Model, including Ophelia co-design methodology, the Basque Country is co-developing an innovative, participatory, and equity-driven health literacy program for youth. Quantitative data were collected using the Health Literacy Questionnaire (n = 430), with cluster analysis identifying 10 health literacy profiles. Qualitative data were gathered through nine co‑design workshops with over 140 participants, exploring barriers and co‑creating solutions for end-users, including people in vulnerable conditions.

Results

The respondent had a mean age of 19 years; the majority lived in cities (71,8%), and gender distribution was broadly balanced, with a slight predominance of girls (57%) over boys (42%). HL, findings showed common difficulties in appraising information, navigating health services, and understanding technical language. Co-design workshops identified 51 barriers related to information overload, low trust in digital health information, high bureaucratic processes, and poor empathic communication. Among the 68 solutions proposed, community-based support, hybrid training, youth-led campaigns, and social media engagement were validated as key components. Mental and sexual health, healthy lifestyles, and addiction prevention were prioritized as main areas to address.

Conclusions

Participatory co‑design supported the development of an inclusive, scalable health literacy programme addressing key informational, structural, and relational barriers. It shows potential to enhance equity, improve access to services and health promotion, and strengthen prevention among youth, while offering a transferable model for NCD prevention across European contexts.

Key messages

• Adolescents and young people face major challenges in accessing, appraising, and using reliable health information, particularly in mental and emotional health domains.

• Combining health literacy profiling with large‑scale co‑design enables the development of equitable, youth‑centred and actionable health promotion programmes.