ArticleHealth literacy research and practice2022
Decision-Making Ability: A Missing Link Between Health Literacy, Contextual Factors, and Health.
Article in Health literacy research and practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Psychological consequences of mammography screening recommendations: a prospective cohort study in Iran.BMC psychology · 2026Article
- The Relationship Between Communicative Health Literacy and Patient Loyalty in China: A Chain Mediation Study Based on Social Exchange Theory.Journal of multidisciplinary healthcare · 2026Article
- Designing Culturally Adapted Digital Mental Health Support Tool for Chinese-Speaking International Students in Australia: A Qualitative Co-design Study.JMIR formative research · 2025Article
- An Ongoing Teacher Professional Development Programme to Enhance Critical Health Literacy Pedagogies and Assessment.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2025Article
- Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study.PLOS global public health · 2025Article
- Differential impacts of digital interactive media and print media on mental health: mediating mechanism of health literacy and group heterogeneity.Frontiers in public health · 2025Article
- Barriers and facilitators of prevention of infections related to cancer: A systematic literature review.Heliyon · 2024Article
- Predictive models for delay in medical decision-making among older patients with acute ischemic stroke: a comparative study using logistic regression analysis and lightGBM algorithm.BMC public health · 2024Article
- Harnessing the power of mindset interventions in health promotion.Journal of education and health promotion · 2023Article
- Health Literacy of People with Intellectual Disabilities: How Meaningful Is the Social Context for a Target Group-Oriented Model of Health Literacy?International journal of environmental research and public health · 2022Article
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Abstract
backgroundHealth literacy has often been described as an important precondition for good health decisions, healthy behaviors, and health. However, reviews reveal low evidence for intervention effectiveness through health literacy. This result calls for more investigations to be done in the pathway from health literacy to health, considering intermediate outcomes of health literacy.
objectiveThis study explores an important immediate objective of health literacy, namely the decision-making ability (DMA) regarding health issues. The study's hypothesis claims the DMA to be an important mediator between health literacy and health outcomes. Furthermore, the study assumes that the effect of the DMA on different health outcomes is not only contingent on health literacy but also on contextual factors. To test the above hypotheses, six different health literacy dimensions and four health outcomes have been analyzed.
methodsCross-sectional data from the Young Adult Survey Switzerland was used for mediation analyses ( KEY
resultsFive of six health literacy dimensions explained the DMA in a linear regression model. The coefficients of the DMA explaining health outcomes were substantially reduced when health literacy items were included into the models (6.1%-20.3%). Furthermore, the associations between health literacy and the health outcomes were fully explained by contextual factors, except in the mental health model.
conclusionsThe results support the hypothesis that higher health literacy levels do not necessarily lead to better health directly. Rather, health literacy is just one of multiple factors contributing to a higher DMA and, further, to favorable health outcomes. The results of this study call for more investigations in the health decision-making process and the role of contextual factors. [
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