Agius Roxane, Debussche Xavier, Panjo Henri, Fosse-Edorh Sandrine, Rigal Laurent
Department of Non-Communicable Diseases and Trauma, Santé publique France, SpFrance, F-94415, Saint-Maurice, France.
CESP, INSERM, UVSQ, Paris-Saclay University, Villejuif, France.
BMC Public Health. 2025 Mar 19;25(1):1061. doi: 10.1186/s12889-025-22118-3.
The aim of this study was to describe and explore the health literacy in people living with type 2 diabetes in mainland France and its association with socioeconomic factors.
ENTRED 3 is a nationally representative French diabetes population-based survey conducted in 2019. Health literacy was measured using two scales from the Health Literacy Questionnaire: ability to actively engage with healthcare providers (HLQ6) and sufficient understanding of health information to know what to do (HLQ9). Gender-stratified analyses and multivariate linear regressions were conducted to study health literacy according to education level and country of birth, adjusting for age and antidiabetic treatment. These analyses were weighted to account for the study's complex sampling design and non-response bias.
Two thousand seven hundred fourteen people living with type 2 diabetes responded to the ENTRED 3 questionnaire. The mean scores for respectively HLQ6 and HLQ9 were significantly higher among men (4.03 (sd 0.02); 4.16 (sd 0.03)) than among women (3.87 (sd 0.01); 3.98 (sd 0.05)). At comparable age and antidiabetic treatment: i) education level were positively associated with HLQ6 and HLQ9 among men; ii) women born in North Africa had lower HLQ6 and faced more pronounced educational inequalities with regards to HLQ9 than women born in France.
This study provides a reference for health literacy in persons living with type 2 diabetes in France and identifies a link between health literacy and socioeconomic factors. Its results represent a significant step in the understanding of the mechanisms of social inequalities in health in France.
本研究旨在描述和探讨法国大陆2型糖尿病患者的健康素养及其与社会经济因素的关联。
ENTRED 3是2019年进行的一项具有全国代表性的基于法国糖尿病患者群体的调查。使用健康素养问卷中的两个量表来衡量健康素养：与医疗服务提供者积极互动的能力（HLQ6）以及对健康信息有足够了解以知道如何行动的能力（HLQ9）。进行了按性别分层的分析和多变量线性回归，以根据教育水平和出生国家研究健康素养，并对年龄和抗糖尿病治疗进行了调整。这些分析进行了加权，以考虑研究的复杂抽样设计和无应答偏差。
2714名2型糖尿病患者对ENTRED 3问卷做出了回应。HLQ6和HLQ9的平均得分在男性中（分别为4.03（标准差0.02）；4.16（标准差0.03））显著高于女性（3.87（标准差0.01）；3.98（标准差0.05））。在可比的年龄和抗糖尿病治疗情况下：i）男性的教育水平与HLQ6和HLQ9呈正相关；ii）出生在北非的女性HLQ6得分较低，并且在HLQ9方面面临比出生在法国的女性更明显的教育不平等。
本研究为法国2型糖尿病患者的健康素养提供了参考，并确定了健康素养与社会经济因素之间的联系。其结果代表了在理解法国健康方面社会不平等机制方面迈出的重要一步。
