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

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  • Jany Rademakers

    (Netherlands Institute for Health Services Research, 3500 BN Utrecht, The Netherlands
    Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, 6200 MD Maastricht, The Netherlands)

  • Monique Heijmans

    (Netherlands Institute for Health Services Research, 3500 BN Utrecht, The Netherlands)

Abstract

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.

Suggested Citation

  • Jany Rademakers & Monique Heijmans, 2018. "Beyond Reading and Understanding: Health Literacy as the Capacity to Act," IJERPH, MDPI, vol. 15(8), pages 1-12, August.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:8:p:1676-:d:162342
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    References listed on IDEAS

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    1. Rademakers, Jany & Nijman, Jessica & Brabers, Anne E.M. & de Jong, Judith D. & Hendriks, Michelle, 2014. "The relative effect of health literacy and patient activation on provider choice in the Netherlands," Health Policy, Elsevier, vol. 114(2), pages 200-206.
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    Cited by:

    1. Svea Gille & Lennert Griese & Doris Schaeffer, 2021. "Preferences and Experiences of People with Chronic Illness in Using Different Sources of Health Information: Results of a Mixed-Methods Study," IJERPH, MDPI, vol. 18(24), pages 1-16, December.
    2. Tan T. Nguyen & Nga T. Le & Minh H. Nguyen & Linh V. Pham & Binh N. Do & Hoang C. Nguyen & Huu C. Nguyen & Tung H. Ha & Hung K. Dao & Phuoc B. Nguyen & Manh V. Trinh & Thinh V. Do & Hung Q. Nguyen & T, 2020. "Health Literacy and Preventive Behaviors Modify the Association between Pre-Existing Health Conditions and Suspected COVID-19 Symptoms: A Multi-Institutional Survey," IJERPH, MDPI, vol. 17(22), pages 1-12, November.
    3. Katharina Achstetter & Julia Köppen & Matthias Haltaufderheide & Philipp Hengel & Miriam Blümel & Reinhard Busse, 2022. "Health Literacy of People with Substitutive Private Health Insurance in Germany and Their Assessment of the Health System Performance According to Health Literacy Levels: Results from a Survey," IJERPH, MDPI, vol. 19(24), pages 1-17, December.
    4. Don Nutbeam & Diane Levin-Zamir & Gill Rowlands, 2018. "Health Literacy in Context," IJERPH, MDPI, vol. 15(12), pages 1-3, November.
    5. Charlotte Demant Klinker & Anna Aaby & Lene Winther Ringgaard & Anneke Vang Hjort & Melanie Hawkins & Helle Terkildsen Maindal, 2020. "Health Literacy is Associated with Health Behaviors in Students from Vocational Education and Training Schools: A Danish Population-Based Survey," IJERPH, MDPI, vol. 17(2), pages 1-13, January.
    6. Anna Aaby & Karina Friis & Bo Christensen & Helle Terkildsen Maindal, 2020. "Health Literacy among People in Cardiac Rehabilitation: Associations with Participation and Health-Related Quality of Life in the Heart Skills Study in Denmark," IJERPH, MDPI, vol. 17(2), pages 1-12, January.
    7. Anna T. Ehmann & Oliver Groene & Monika A. Rieger & Achim Siegel, 2020. "The Relationship between Health Literacy, Quality of Life, and Subjective Health: Results of a Cross-Sectional Study in a Rural Region in Germany," IJERPH, MDPI, vol. 17(5), pages 1-12, March.

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