Department of Social Work, Bern University of Applied Sciences, Bern, Switzerland.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Health Promot Int. 2022 Feb 17;37(1). doi: 10.1093/heapro/daab054.
Previous studies have found substantial correlations between health literacy and various health outcomes. However, the role of social and personal factors in those links remains understudied. Applying a moderation approach, we assume that these factors function as conversion factors on the associations between health literacy and health outcomes. Consequently, we test if associations between health literacy and health outcomes are stronger among young male adults who score high in conversion factors compared to those who score low. Cross-sectional data from the Young Adult Survey Switzerland were used for the analyses (n = 9339, age = 18-25). Multiple logistic regression analyses were applied to estimate associations between health literacy and health. Moderator analyses with three conversion factors and five health outcomes were conducted. For each health outcome at least one conversion factor moderated the association between health literacy and health according to the hypothesis. Although strength and form of the moderation effect differ across analyses, generally stronger associations were found among groups with beneficial social or personal factors. The present findings support the hypothesis that conversion factors play a crucial role in the associations between health literacy and health. The findings, thus, point towards a potential risk of linear health literacy approaches that assume equal benefits from increased health literacy. Individuals with beneficial social and personal factors (those already privileged) may enjoy greater health benefits from interventions improving health literacy.
先前的研究发现，健康素养与各种健康结果之间存在实质性关联。然而，社会和个人因素在这些关联中的作用仍未得到充分研究。我们采用调节方法，假设这些因素作为健康素养与健康结果之间关联的转换因素起作用。因此，我们检验在转换因素得分高的年轻男性成年人中，健康素养与健康结果之间的关联是否比得分低的人更强。本分析使用了来自瑞士青年调查的横断面数据（n=9339，年龄为 18-25 岁）。应用多变量逻辑回归分析来估计健康素养与健康之间的关联。进行了三项转换因素和五项健康结果的调节分析。根据假设，对于每种健康结果，至少有一种转换因素调节了健康素养与健康之间的关联。尽管调节效应的强度和形式在分析中有所不同，但在具有有益的社会或个人因素的群体中，关联通常更强。本研究结果支持了转换因素在健康素养与健康之间的关联中起着至关重要的作用这一假设。因此，这些发现表明，线性健康素养方法假设增加健康素养会带来同等的健康益处，存在潜在的风险。具有有益的社会和个人因素（那些已经享有特权的人）的个体可能会从提高健康素养的干预措施中获得更大的健康益处。
