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Open AccessArticle

Beyond Reading and Understanding: Health Literacy as the Capacity to Act

1
Netherlands Institute for Health Services Research, 3500 BN Utrecht, The Netherlands
2
Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, 6200 MD Maastricht, The Netherlands
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(8), 1676; https://doi.org/10.3390/ijerph15081676
Received: 9 May 2018 / Revised: 11 July 2018 / Accepted: 24 July 2018 / Published: 7 August 2018
(This article belongs to the Special Issue Health Literacy in Context—Settings, Media, and Populations)
Many health literacy interventions have a limited focus on functional/cognitive skills. In psychosocial models, the capacity to act however is seen as a major driver of behavioural change. This aspect is often lacking in health literacy concepts. In this study, we examine the impact of both aspects of health literacy (functional/cognitive and capacity to act) on specific healthcare outcomes (healthcare use, experiences with patient-centered care, shared-decision making, and self-management). In a sample of a national panel of people with a chronic disease (NPCD), questions about health literacy, patient activation, and outcomes were asked. The results indicated that 39.9% had limited HL levels and 36.9% had a low activation score. Combined, 22.7% of the sample scored low on both aspects, whereas 45.8% had adequate levels on both. Patients who score low on both use more healthcare and have less positive experiences with patient-centered care, shared decision making, and self-management. Patients who have adequate competency levels in both respects have the best outcomes. Both cognitive and non-cognitive aspects of health literacy are important, and they enhance each other. The capacity to act is especially important for the extent to which people feel able to self-manage. View Full-Text
Keywords: health literacy; health determinants; health competencies; health outcomes; patient-centered care; definitions; conceptual models health literacy; health determinants; health competencies; health outcomes; patient-centered care; definitions; conceptual models
MDPI and ACS Style

Rademakers, J.; Heijmans, M. Beyond Reading and Understanding: Health Literacy as the Capacity to Act. Int. J. Environ. Res. Public Health 2018, 15, 1676.

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