DEFACTUM, Central Denmark Region, Aarhus, Denmark.
Department of Public Health, Aarhus University, Aarhus, Denmark.
BMC Public Health. 2024 Oct 8;24(1):2739. doi: 10.1186/s12889-024-20223-3.
Managing a long-term condition requires higher health literacy. Social networks may play a crucial role for self-management. However, the pathway is not entirely understood. This study aimed to examine whether the association between social support and self-rated health is mediated by health literacy among individuals with a long-term condition.
This cross-sectional study used data from the "How are you?" 2021 survey in Central Denmark Region. Social support was assessed using a single question, health literacy with two dimensions from the Health Literacy Questionnaire (HLQ): 'Understanding health information' and 'Engaging with healthcare providers', and self-rated health with a single question from SF-36. Multiple logistic regression analyses were used to examine the associations, and multiple mediation analyses were performed using the Karlson-Holm-Breen method.
A total of 10,787 individuals with a long-term condition were included in the study, whereas 6% (n = 595) reported a low level of social support. Both health literacy scales mediated the association between social support and self-rated health, particularly the ability to engage with healthcare providers, accounting for 25% of the variance. After adjustment for sociodemographic factors, individuals with a low level of social support had significantly higher odds of reporting difficulties in understanding health information (OR 2.53 (95% CI: 1.84-3.48)) and engaging with healthcare providers (OR 3.77 (95% CI: 2.96-4.79)).
Health literacy, particularly the ability to engage with healthcare providers, was a mediator between social support and self-rated health. Additionally, a low level of social support was associated with higher odds of reporting lower health literacy. These findings suggest that strategies to enhance health literacy, improve health outcomes, and reduce health inequities may benefit from strengthening individuals' social network, particularly focusing on those with limited support.
管理长期疾病需要较高的健康素养。社交网络可能对自我管理起着至关重要的作用。然而，其作用机制尚不完全清楚。本研究旨在检验在患有长期疾病的人群中，社会支持与自我报告健康状况之间的关联是否通过健康素养来介导。
本横断面研究使用了来自丹麦中部地区“你好吗？”2021 年调查的数据。社会支持通过一个问题来评估，健康素养使用健康素养问卷（HLQ）的两个维度来评估：“理解健康信息”和“与医疗保健提供者互动”，自我报告健康状况使用 SF-36 的一个问题来评估。使用多元逻辑回归分析来检验关联，使用 Karlson-Holm-Breen 方法进行多重中介分析。
共纳入 10787 名患有长期疾病的个体，其中 6%（n=595）报告社会支持水平较低。两个健康素养量表都中介了社会支持与自我报告健康状况之间的关联，特别是与医疗保健提供者互动的能力，占方差的 25%。在调整社会人口因素后，社会支持水平较低的个体报告在理解健康信息（OR 2.53（95%CI：1.84-3.48））和与医疗保健提供者互动（OR 3.77（95%CI：2.96-4.79））方面存在更高的困难的可能性显著增加。
健康素养，特别是与医疗保健提供者互动的能力，是社会支持与自我报告健康状况之间的中介。此外，社会支持水平较低与报告健康素养较低的可能性更高相关。这些发现表明，提高健康素养、改善健康结果和减少健康不平等的策略可能受益于增强个人社交网络，特别是关注那些支持有限的人群。
