An empirical test of the Health Empowerment Model: Does patient empowerment moderate the effect of health literacy on health status?

Patient Educ Couns. 2018 Mar;101(3):511-517. doi: 10.1016/j.pec.2017.09.004. Epub 2017 Sep 6.

Abstract

Objective: The Health Empowerment Model (Schulz & Nakamoto, 2013) advocates that the effects of health literacy and empowerment are intertwined on health outcomes. This study aims to test this assumption in the context of health status as a patient outcome.

Methods: A cross-sectional study was conducted with a sample of 302 participants between June and December 2015. The participants' health literacy (using the NVS and S-TOFHLA tests), empowerment and self-reported health status were assessed.

Results: The participants having a high level of patient empowerment and concurrent adequate health literacy (the so-called 'effective self-managers') reported better health status compared to patients who had either lower health literacy and/or lower empowerment scores (P<0.05). Moreover, the meaningfulness (b=0.053, t(297)=2.29, P=0.02) and competence (b=0.07, t(297)=2.47, P=0.01) sub-dimensions of patient empowerment moderated the effect of the NVS on current health status.

Conclusion: The study provides evidence for the independence of health literacy and empowerment and partial evidence for their interaction predicting health status.

Practice implications: Our findings highlight that health literacy and patient empowerment (in particular its competence and meaningfulness sub-facets) are crucial patient-related variables, to be taken into consideration simultaneously, during screening and health promotion campaigns fostering health status in the general population.

Keywords: Empowerment; Health Empowerment Model; Health literacy; Health status.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Health Literacy*
  • Health Promotion
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Patient Participation*
  • Power, Psychological*
  • Self Care*
  • Surveys and Questionnaires