ArticleBMC public health2025
Health literacy and hypertension-related multimorbidity: unravelling the mediating role of self-management - insights from the lifelines cohort study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed.
- Determinants and experiences of hypertension among market women at wednesday market, sunyani: a qualitative study.BMC public health · 2026Article
- Article
- Association between health literacy and chronic diseases in Anhui Province: findings from a province-wide cross-sectional survey of 16,067 individuals.Scientific reports · 2025Article
- Knowledge of Hypertension and Self-Blood Pressure Measurement Skills in Spain.Journal of primary care & community healthObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeople with limited health literacy and hypertension may lack the self-management skills needed to manage their illness, contributing to the onset and progression of important adverse health outcomes (e.g., multimorbidity). This study aimed to assess the association between health literacy and the onset and progression of hypertension-related multimorbidity among people with hypertension and whether this association is mediated by components of self-management (i.e., motivation, self-efficacy beliefs and problem-solving).
methodsThe study sample included data from 21,725 adult participants with hypertension who were followed in the Lifelines Cohort Study. Using causal mediation analysis with natural effect models, the total and direct effect of health literacy on hypertension-related multimorbidity and the indirect effects of motivation, self-efficacy beliefs and problem-solving were studied.
resultsFirst, after controlling for age, sex, smoking status, education level and monthly income, the total and direct effects of health literacy on the onset of hypertension-related multimorbidity were null (OR: 1.00, 95% CI: 0.99-1.01); however, an increase in problem-solving scores had an indirect effect on the onset of hypertension-related multimorbidity (OR: 0.99, 95% CI: 0.98-0.99). Second, a change from limited health literacy to adequate health literacy (OR: 0.99, 95% CI: 0.98-0.99) and an increase in motivation (OR: 0.99; 95% CI: 0.99-1.00), self-efficacy beliefs (OR: 0.99; 95% CI: 0.98-0.99) and problem-solving (OR: 0.99; 95% CI: 0.98-0.99) scores had direct and indirect effects, respectively, on the progression of hypertension-related multimorbidity.
conclusionsA change from limited health literacy to adequate health literacy had no direct effect on the onset of hypertension-related multimorbidity but did decrease the likelihood of its progression. Problem-solving indirectly mediated only the onset; meanwhile, motivation, self-efficacy beliefs and problem-solving mediated the progression of hypertension-related multimorbidity. Improving health literacy and self-management skills can play a crucial role in preventing or delaying the onset or progression of hypertension-related multimorbidity. These improvements can significantly reduce the disease burden for individuals with limited health literacy and those living with hypertension-related multimorbidity.
Indexed as
Identifiers
What OpenQuestion holds
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.