ArticleInternational journal of environmental research and public health2018
Beyond Reading and Understanding: Health Literacy as the Capacity to Act.
Article in International journal of environmental research and public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Identifying Strengths and Weaknesses in Health Literacy among Medical Students: A Systematic Review.BMC medical education · 2025Pooled it
- Tailoring for Health Literacy in the Design and Development of eHealth Interventions: Systematic Review.JMIR human factors · 2025Pooled it
- Three-Dimensional-Printed Models and Shared Decision-Making: A Cluster Randomized Clinical Trial.JAMA network open · 2025Trial
- Online cancer forums and complementary and alternative medicine in cancer care: effects of ehealth literacy and psychological distress on use and attitudes.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Self-Care Experiences and Support Needs of Community-Dwelling Older Adults With Multimorbidity: A Qualitative Study Informed by the Caring Life-Course Theory.Journal of clinical nursing · 2026Article
- Older people's health literacy on COVID-related health behaviours during the pandemic - Results from the SWEOLD 2021 study in Sweden.Scandinavian journal of public health · 2026Article
- Organisational health literacy in healthcare in Europe: a content analysis to explore stakeholders perspectives for supporting the adoption of effective strategies and interventions.Archives of public health = Archives belges de sante publique · 2026Article
- Implementation fidelity of a pharmacist-led intervention program to improve a high serum phosphate concentration in haemodialysis patients: a mixed-methods study.International journal of clinical pharmacy · 2026Article
- Article
- Associations Between Short-Video Platform Use and Health Across Health Distribution and Usage Behaviors in China: Cross-Sectional Questionnaire Study.Journal of medical Internet research · 2026Article
- Pelvic pain & endometriosis: the development of a patient-centred e-health resource for those affected by endometriosis-associated dyspareunia.BMC medical informatics and decision making · 2025Article
- Health Literacy and Self-Efficacy in Parents of Toddlers-A Cross-Sectional Study.Nursing open · 2025Article
- Relevant determinants of Dutch patients' informed decision-making and use of online access to medical records.Health promotion international · 2025Article
- Assessment of public literacy in TB prevention and control in the National 13th Five-Year plan for Tuberculosis Prevention and Control (2016-2020) in China.BMC health services research · 2025Article
- How do citizens with low health insurance literacy choose a health insurance policy in the Netherlands? An interview study.BMC health services research · 2024Article
- Impact of a transformative health literacy model for Thai older adults with hypertension.BMC research notes · 2024Article
- Patient online access to general practice medical records: A qualitative study on patients' needs and expectations.Health information management : journal of the Health Information Management Association of Australia · 2024Article
- Visual decision aids to support communication and shared decision-making: How are they valued and used in practice?PloS one · 2024Article
- When Positive is Negative: Health Literacy Barriers to Patient Access to Clinical Laboratory Test Results.The journal of applied laboratory medicine · 2023Article
- Testing a single item screener to support family doctors in identifying patients with limited health literacy: convergent validity of the SILS and the HLS-EU-Q16.BMC primary care · 2023Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.