{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:44:29Z","timestamp":1792737869234,"version":"4.5.0"},"reference-count":95,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004726","name":"Ministry of Health","doi-asserted-by":"publisher","award":["ZMV I 1-2518 004"],"award-info":[{"award-number":["ZMV I 1-2518 004"]}],"id":[{"id":"10.13039\/501100004726","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005721","name":"Bielefeld University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005721","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Health literacy (HL) is increasingly recognized as essential for preventing and managing chronic illness but also for strengthening health resources and skills. However, studies on HL of people with chronic illness that adopt a multidimensional approach encompassing the three HL domains health care, disease prevention, and health promotion, remain scarce. This study aims to (a) compare HL across these three domains in individuals with chronic somatic illness, chronic mental illness and those without any chronic illness, (b) to explore where difficulties in managing health-related information occur and how these differ between groups, and (c) to analyze the relationship between demographic, social, and psychological factors and HL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from a quantitative cross-sectional survey in Germany were stratified according to respondents with at least one chronic somatic illness, at least one chronic mental illness and without chronic illness. The survey was conducted by means of paper-assisted personal interviews. HL was measured in three domains health care, disease prevention and health promotion. Age, educational level, social status, financial resources, number of chronic illnesses, social support, and self-efficacy were included in the analysis as potential determinants of HL. Differences between groups were analyzed using bivariate statistics; multiple linear regressions were calculated to examine relationships between potential determinants and HL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Respondents with chronic mental illness showed lowest HL, followed by those with chronic somatic illness. Respondents without chronic illness achieved highest HL. This pattern was consistent across all three HL domains. Among all groups, HL was lowest in the domain of health promotion. Notable differences emerged in perceived difficulties, with respondents with mental illnesses reporting the most significant challenges. Self-efficacy and education level showed a positive association with HL across all groups, while social support was positively associated with HL among individuals with chronic mental illness. For respondents with chronic somatic illness, age was negatively associated with HL, whereas social status showed a positive association. Female respondents without chronic illness and those with chronic somatic illness demonstrated higher HL compared to male respondents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study advances the understanding of HL among individuals with chronic illness and highlights the need for a greater differentiation among disease groups and HL domains in future research. Particular attention should be paid to people with chronic mental illness, whose lower HL levels increase their vulnerability.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1523723","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T05:21:33Z","timestamp":1739856093000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Health literacy and chronic disease: a comparison of somatic and mental illness"],"prefix":"10.3389","volume":"13","author":[{"given":"Lennert","family":"Griese","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Schaeffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"ref1","volume-title":"Noncommunicable diseases","year":"2023"},{"key":"ref2","volume-title":"Monitoring noncommunicable disease commitments in Europe 2021: Are we on track to reach targets 10 years after the Moscow declaration and first United Nations high-level meeting?","year":"2021"},{"key":"ref3","volume-title":"Noncommunicable diseases country profiles","year":"2018"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"6","DOI":"10.25646\/8456","article-title":"Gesundheitliche Lage von Erwachsenen in Deutschland \u2013 Ergebnisse zu ausgew\u00e4hlten Indikatoren der Studie GEDA 2019\/2020-EHIS","volume":"2021","author":"Heidemann","year":"2021","journal-title":"J Health Monit"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1024\/85604-000","article-title":"Chronische Krankheit und Health Literacy","volume-title":"Health literacy: Forschungsstand und Perspektiven","author":"Schaeffer","year":"2017"},{"key":"ref6","volume-title":"Unending work and care: Managing chronic illness at home","author":"Corbin","year":"1988"},{"key":"ref7","volume-title":"Weiterleben lernen: Verlauf und Bew\u00e4ltigung chronischer Krankheit","author":"Corbin","year":"2004"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1177\/17423953211035472","article-title":"The importance of health literacy for self-management: a scoping review of reviews","volume":"18","author":"van der Gaag","year":"2022","journal-title":"Chronic Illn"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1016\/S0140-6736(21)02143-7","article-title":"Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic","volume":"398","author":"Santomauro","year":"2021","journal-title":"Lancet"},{"key":"ref10","volume-title":"Mental health and COVID-19: Early evidence of the pandemic\u2019s impact: Scientific brief, 2 March 2022","year":"2022"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1002\/wps.20128","article-title":"Risks of all-cause and suicide mortality in mental disorders: a meta-review","volume":"13","author":"Chesney","year":"2014","journal-title":"World Psychiatry"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1177\/0020764019873683","article-title":"Peculiarities of health literacy in people with mental disorders: a cross-sectional study","volume":"66","author":"Mantell","year":"2020","journal-title":"Int J Soc Psychiatry"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"405","DOI":"10.3238\/arztebl.2019.0405","article-title":"Mortality and medical comorbidity in the severely mentally ill","volume":"116","author":"Schneider","year":"2019","journal-title":"Dtsch Arztebl Int"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/heapro\/13.4.349","article-title":"Health promotion glossary","volume":"13","author":"Nutbeam","year":"1998","journal-title":"Health Promot Int"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1471-2458-12-80","article-title":"Health literacy and public health: a systematic review and integration of definitions and models","volume":"12","author":"S\u00f8rensen","year":"2012","journal-title":"BMC Public Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1007\/s11606-020-06407-8","article-title":"What is the prevalence of low health literacy in European Union member states? A systematic review and Meta-analysis","volume":"36","author":"Baccolini","year":"2021","journal-title":"J Gen Intern Med"},{"key":"ref17","volume-title":"International report on the methodology, results, and recommendations of the European health literacy population survey 2019\u20132021 (HLS","year":"2021"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"723","DOI":"10.3238\/arztebl.m2021.0310","article-title":"Health literacy in Germany-findings of a representative follow-up survey","volume":"118","author":"Schaeffer","year":"2021","journal-title":"Dtsch Arztebl Int"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"97","DOI":"10.7326\/0003-4819-155-2-201107190-00005","article-title":"Low health literacy and health outcomes: an updated systematic review","volume":"155","author":"Berkman","year":"2011","journal-title":"Ann Intern Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2869","DOI":"10.1007\/s11136-016-1298-2","article-title":"The association between health literacy and self-management abilities in adults aged 75 and older, and its moderators","volume":"25","author":"Geboers","year":"2016","journal-title":"Qual Life Res"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.pec.2014.10.006","article-title":"Functional, communicative and critical health literacy of chronic disease patients and their importance for self-management","volume":"98","author":"Heijmans","year":"2015","journal-title":"Patient Educ Couns"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"747","DOI":"10.15171\/ijhpm.2015.151","article-title":"Health literacy impact on National Healthcare Utilization and expenditure","volume":"4","author":"Rasu","year":"2015","journal-title":"Int J Health Policy Manag"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1097\/JCN.0000000000000229","article-title":"Health literacy and heart failure: a systematic review","volume":"31","author":"Cajita","year":"2016","journal-title":"J Cardiovasc Nurs"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1186\/s12889-018-6070-9","article-title":"Relation between health literacy, self-care and adherence to treatment with oral anticoagulants in adults: a narrative systematic review","volume":"18","author":"Cabellos-Garcia","year":"2018","journal-title":"BMC Public Health"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00592-017-1071-1","article-title":"Health literacy in type 2 diabetes patients: a systematic review of systematic reviews","volume":"55","author":"Caruso","year":"2018","journal-title":"Acta Diabetol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.spinee.2017.09.005","article-title":"The importance and impact of patients' health literacy on low back pain management: a systematic review of literature","volume":"18","author":"Edward","year":"2018","journal-title":"Spine J"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e40210","DOI":"10.1371\/journal.pone.0040210","article-title":"Impact of health literacy in patients with chronic musculoskeletal disease \u2013 systematic review","volume":"7","author":"Loke","year":"2012","journal-title":"PLoS One"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1007\/s00296-016-3566-4","article-title":"Medication adherence in patients with rheumatoid arthritis: why do patients not take what we prescribe?","volume":"36","author":"Wong","year":"2016","journal-title":"Rheumatol Int"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e0259815","DOI":"10.1371\/journal.pone.0259815","article-title":"The role of health literacy in cancer care: a mixed studies systematic review","volume":"16","author":"Holden","year":"2021","journal-title":"PLoS One"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1188\/20.ONF.18-32","article-title":"Health literacy in adult oncology: an integrative review","volume":"47","author":"Kieffer Campbell","year":"2020","journal-title":"Oncol Nurs Forum"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1186\/s12931-022-02290-5","article-title":"Health literacy in asthma and chronic obstructive pulmonary disease (COPD) care: a narrative review and future directions","volume":"23","author":"Poureslami","year":"2022","journal-title":"Respir Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1016\/j.jaci.2012.01.040","article-title":"Health literacy and asthma","volume":"129","author":"Rosas-Salazar","year":"2012","journal-title":"J Allergy Clin Immunol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1007\/s40620-022-01537-0","article-title":"Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease: a systematic review","volume":"36","author":"Billany","year":"2023","journal-title":"J Nephrol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1093\/ndt\/gfx293","article-title":"Health literacy and patient outcomes in chronic kidney disease: a systematic review","volume":"33","author":"Taylor","year":"2018","journal-title":"Nephrol Dial Transplant"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s11096-022-01470-z","article-title":"Association between health literacy and medication adherence in chronic diseases: a recent systematic review","volume":"45","author":"Hyvert","year":"2023","journal-title":"Int J Clin Pharm"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"2999","DOI":"10.1016\/j.pec.2022.05.008","article-title":"\"a bit of everything\": health literacy interventions in chronic conditions \u2013 a systematic review","volume":"105","author":"Larsen","year":"2022","journal-title":"Patient Educ Couns"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1007\/s11553-021-00843-y","article-title":"Gesundheitskompetenz bei chronischer Krankheit in Deutschland: ein Scoping Review","volume":"17","author":"Griese","year":"2022","journal-title":"Pr\u00e4v Gesundheitsf"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1016\/j.pec.2016.01.020","article-title":"Health literacy and adherence to medical treatment in chronic and acute illness: a meta-analysis","volume":"99","author":"Miller","year":"2016","journal-title":"Patient Educ Couns"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1027\/1016-9040\/a000350","article-title":"Association between health literacy, eHealth literacy, and health outcomes among patients with long-term conditions","volume":"24","author":"Neter","year":"2019","journal-title":"Eur Psychol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"112499","DOI":"10.1016\/j.psychres.2019.112499","article-title":"Health literacy in people living with mental illness: a latent profile analysis","volume":"280","author":"Degan","year":"2019","journal-title":"Psychiatry Res"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e009627","DOI":"10.1136\/bmjopen-2015-009627","article-title":"Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in 29 473 Danish citizens","volume":"6","author":"Friis","year":"2016","journal-title":"BMJ Open"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1007\/s00103-015-2200-z","article-title":"Gesundheitskompetenz von Erwachsenen in Deutschland: Ergebnisse der Studie \u201cGesundheit in Deutschland aktuell\u201d (GEDA)","volume":"58","author":"Jordan","year":"2015","journal-title":"Bundesgesundheitsbl"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.1111\/eip.13090","article-title":"Health literacy of people living with mental illness or substance use disorders: a systematic review","volume":"15","author":"Degan","year":"2021","journal-title":"Early Interv Psychiatry"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-3-662-67055-2_38","article-title":"Gesundheitskompetenz im Kontext psychischer Erkrankungen: Konzeptanalyse, Forschungsstand, Interventionsans\u00e4tze","volume-title":"Gesundheitskompetenz","author":"Baumeister","year":"2023"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"53","DOI":"10.51952\/9781447344520.007","article-title":"The concept of mental health literacy","volume-title":"International handbook of health literacy: research, practice and policy across the lifespan","author":"Jorm","year":"2019"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"197","DOI":"10.3109\/09638237.2014.910646","article-title":"Measuring mental health literacy \u2013 a review of scale-based measures","volume":"23","author":"O'Connor","year":"2014","journal-title":"J Ment Health"},{"key":"ref47","volume-title":"European health interview survey (EHIS wave 3) \u2014 Methodological manual","year":"2018"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1186\/1471-2458-13-948","article-title":"Measuring health literacy in populations: illuminating the design and development process of the European health literacy survey questionnaire (HLS-EU-Q)","volume":"13","author":"S\u00f8rensen","year":"2013","journal-title":"BMC Public Health"},{"key":"ref49","volume-title":"The conceptualisation, measurement, and coding of education in German and cross-National Surveys. GESIS survey guidelines","author":"Schneider","year":"2016"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1037\/0278-6133.19.6.586","article-title":"Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy, white women","volume":"19","author":"Adler","year":"2000","journal-title":"Health Psychol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1007\/s00127-006-0051-5","article-title":"Negative life events, social support and gender difference in depression: a multinational community survey with data from the ODIN study","volume":"41","author":"Dalgard","year":"2006","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"ref52","volume-title":"Allgemeine Selbstwirksamkeit Kurzskala (ASKU)","author":"Beierlein","year":"2014"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1007\/s10597-015-9951-8","article-title":"Health literacy among people with serious mental illness","volume":"52","author":"Clausen","year":"2016","journal-title":"Community Ment Health J"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1177\/14034948211045921","article-title":"Multimorbidity and health literacy: a population-based survey among 28,627 Danish adults","volume":"51","author":"Pedersen","year":"2021","journal-title":"Scand J Public Health"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1186\/s12889-023-15136-6","article-title":"Association between multiple chronic conditions and insufficient health literacy: cross-sectional evidence from a population-based sample of older adults living in Switzerland","volume":"23","author":"Wieczorek","year":"2023","journal-title":"BMC Public Health"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"988782","DOI":"10.3389\/fpubh.2022.988782","article-title":"Differences in health literacy domains among migrants and their descendants in Germany","volume":"10","author":"Berens","year":"2022","journal-title":"Front Public Health"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/2333721416630492","article-title":"Health literacy and older adults: a systematic review","volume":"2","author":"Chesser","year":"2016","journal-title":"Gerontol Geriatr Med"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.adolescence.2017.11.010","article-title":"Adolescent health literacy and health behaviors: a systematic review","volume":"62","author":"Fleary","year":"2018","journal-title":"J Adolesc"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1186\/s12889-018-5054-0","article-title":"Generic health literacy measurement instruments for children and adolescents: a systematic review of the literature","volume":"18","author":"Okan","year":"2018","journal-title":"BMC Public Health"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1093\/heapro\/dax012","article-title":"Health literacy in old age: results of a German cross-sectional study","volume":"33","author":"Vogt","year":"2018","journal-title":"Health Promot Int"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1007\/s00787-022-02060-0","article-title":"A systematic review of the mental health changes of children and young people before and during the COVID-19 pandemic","volume":"32","author":"Kauhanen","year":"2023","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"e173","DOI":"10.1017\/S2045796020000888","article-title":"Increase in prevalence of current mental disorders in the context of COVID-19: analysis of repeated nationwide cross-sectional surveys","volume":"29","author":"Winkler","year":"2020","journal-title":"Epidemiol Psychiatr Sci"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1080\/10810730.2010.501094","article-title":"Health literacy: a second decade of distinction for Americans","volume":"15","author":"Parker","year":"2010","journal-title":"J Health Commun"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s00103-023-03671-x","article-title":"Die Versorgung von Menschen mit psychischen Erkrankungen in Deutschland aus Perspektive des Gesundheits- und Sozialsystems: Aktuelle Entwicklungsbedarfe","volume":"66","author":"Bramesfeld","year":"2023","journal-title":"Bundesgesundheitsblatt"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1007\/s00115-016-0147-4","article-title":"Ambulante fach\u00e4rztliche Versorgung psychischer St\u00f6rungen Kleine regionale Unterschiede im Bedarf, gro\u00dfe regionale Unterschiede in der Versorgungsdichte","volume":"87","author":"Jacobi","year":"2016","journal-title":"Nervenarzt"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1186\/s12888-022-04146-0","article-title":"Information needs and sources of information among people with depression and anxiety: a scoping review","volume":"22","author":"Chan","year":"2022","journal-title":"BMC Psychiatry"},{"key":"ref67","first-page":"15","article-title":"A model for the nursing care of the chronically ill","volume-title":"Chronically ill persons and their everyday life: The model of Mieke Grypdonck applied to female patients who have undergone a kidney transplantation","author":"Grypdonck","year":"2005"},{"key":"ref68","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/B978-012373960-5.00584-0","article-title":"Health literacy","volume-title":"International encyclopedia of public health","author":"Kickbusch","year":"2008"},{"key":"ref69","first-page":"465","volume-title":"Nationaler Aktionsplan Gesundheitskompetenz. Die Gesundheitskompetenz in Deutschland st\u00e4rken","author":"Schaeffer","year":"2018"},{"key":"ref70","article-title":"Shanghai declaration on promoting health in the 2030 agenda for sustainable development","year":"2016"},{"key":"ref71","volume-title":"Global action plan for the prevention and control of noncommunicable diseases 2013\u20132020","year":"2013"},{"key":"ref72","volume-title":"SPOTLIGHT Gesundheit: Vision einer nationalen Gesundheitsplattform: Strategien f\u00fcr eine vertrauensw\u00fcrdige Informationsarchitektur im Gesundheitswesen","year":"2024"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/28355245.2023.2263355","article-title":"Artificial intelligence and health literacy\u2014proceed with caution","volume":"1","author":"Nutbeam","year":"2023","journal-title":"Health Lit Commun Open"},{"key":"ref74","volume-title":"Comparative report of health literacy in eight EU member states; the European health literacy survey HLS-EU. Second Revised and Extended Version","year":"2012"},{"key":"ref75","volume-title":"Health literacy of Slovenian adults: Results of the Slovenian health literacy survey (HLS-SI19)","author":"Vrdelja","year":"2022"},{"key":"ref76","volume-title":"Health Literacy Survey Schweiz 2019\u20132021: Schlussbericht (V2) im Auftrag des Bundesamtes f\u00fcr Gesundheit BAG","author":"De Gani","year":"2021"},{"key":"ref77","volume-title":"Factsheet \u00d6sterreichische Gesundheitskompetenz-Erhebung 2020","author":"Griebler","year":"2021"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"e0288381","DOI":"10.1371\/journal.pone.0288381","article-title":"How socioeconomically disadvantaged people access, understand, appraise, and apply health information: a qualitative study exploring health literacy skills","volume":"18","author":"Stormacq","year":"2023","journal-title":"PLoS One"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"704","DOI":"10.3390\/healthcare11050704","article-title":"Health literacy among Japanese college students: association with healthy lifestyle and subjective health status","volume":"11","author":"Yokoyama","year":"2023","journal-title":"Healthcare (Basel)"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"115","DOI":"10.3233\/ISU-230193","article-title":"Health literacy action framework for health emergencies and infodemics","volume":"43","author":"Okan","year":"2023","journal-title":"Inf Serv Use"},{"key":"ref81","volume-title":"Public health research agenda for managing infodemics","year":"2021"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1007\/s00103-020-03192-x","article-title":"Wie informieren sich die Menschen in Deutschland zum Thema Gesundheit? Erkenntnisse aus der ersten Welle von HINTS Germany","volume":"63","author":"Baumann","year":"2020","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.nurpra.2021.12.024","article-title":"Health information seeking and its achievements in patients with chronic disease","volume":"18","author":"Merati-Fashi","year":"2022","journal-title":"J Nurs Pract"},{"key":"ref84","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3390\/ijerph17228682","article-title":"Subjective generic health literacy and its associated factors among adolescents: results of a population-based online survey in Germany","volume":"17","author":"Loer","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref85","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.3928\/24748307-20180313-01","article-title":"Health literacy, self-efficacy, and associated factors among patients with diabetes","volume":"2","author":"Xu","year":"2018","journal-title":"Health Lit Res Pract"},{"key":"ref86","doi-asserted-by":"publisher","first-page":"2259","DOI":"10.1186\/s12889-023-17145-x","article-title":"Health literacy and the role of social support in different age groups: results of a German cross-sectional survey","volume":"23","author":"Klinger","year":"2023","journal-title":"BMC Public Health"},{"key":"ref87","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1016\/S0277-9536(03)00329-0","article-title":"Health literacy, social support, and health: a research agenda","volume":"58","author":"Lee","year":"2004","journal-title":"Soc Sci Med"},{"key":"ref88","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.3928\/24748307-20170427-01","article-title":"Health literacy in a social context: review of quantitative evidence","volume":"1","author":"Sentell","year":"2017","journal-title":"Health Lit Res Pract"},{"key":"ref89","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1093\/eurpub\/ckv043","article-title":"Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU)","volume":"25","author":"S\u00f8rensen","year":"2015","journal-title":"Eur J Pub Health"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"1226420","DOI":"10.3389\/fpubh.2023.1226420","article-title":"Health literacy: association with socioeconomic determinants and the use of health services in Spain","volume":"11","author":"Tamayo-Fonseca","year":"2023","journal-title":"Front Public Health"},{"key":"ref91","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1146\/annurev-publhealth-090419-102529","article-title":"Understanding and responding to health literacy as a social determinant of health","volume":"42","author":"Nutbeam","year":"2021","journal-title":"Annu Rev Public Health"},{"key":"ref92","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1080\/10410236.2016.1255846","article-title":"Subjective estimation of health literacy\u2014what is measured by the HLS-EU scale and how is it linked to empowerment?","volume":"33","author":"Gerich","year":"2018","journal-title":"Health Commun"},{"key":"ref93","doi-asserted-by":"publisher","first-page":"e26","DOI":"10.1055\/a-1807-0853","article-title":"DNVF Memorandum Gesundheitskompetenz (Teil II) \u2013 Operationalisierung und Messung von Gesundheitskompetenz aus Sicht der Versorgungsforschung","volume":"84","author":"Stock","year":"2022","journal-title":"Gesundheitswesen"},{"key":"ref94","volume-title":"V. Basisdaten Psychische Erkrankungen: Stand April 2024","year":"2024"},{"key":"ref95","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.pec.2017.09.002","article-title":"Health literacy and coronary artery disease: a systematic review","volume":"101","author":"Ghisi","year":"2018","journal-title":"Patient Educ Couns"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1523723\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T05:21:45Z","timestamp":1739856105000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1523723\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,18]]},"references-count":95,"alternative-id":["10.3389\/fpubh.2025.1523723"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1523723","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,18]]},"article-number":"1523723"}}