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Using health literacy profiles to tailor interventions to the needs of chronic disease patients.

Heijmans, M., Waverijn, G., Rijken, M., Osborne, R., Rademakers, J. Using health literacy profiles to tailor interventions to the needs of chronic disease patients. European Journal of Public Health: 2015, 25(spl. 3) 45. Abstract: 8th European Public Health Conference: "Health in Europe - from global to local policies, methods and practices". 14-17 oktober 2015 in Milan.
Health literacy (HL) is an important prerequisite for successful self-management and a determinant of health care use in chronic disease. HL is a multidimensional concept covering several functional, social and psychological dimensions. When developing interventions to improve HL it is an important question on which of these dimensions one should focus to offer care that best fits the needs of individual patients. We surveyed both the health literacy and self-management capabilities of a representative sample of 1.826 patients with chronic conditions or long term disabilities in the Netherlands. The Health Literacy Questionnaire (HLQ) assessed 9 independent HL dimensions. Using cluster analysis we looked for subgroups of patients across the 9 different HL profiles. Cluster analysis produced a 7-cluster solution, identifying stable and clinically meaningful subgroups of patients. In each subgroup patients had at least some strengths but also reported limitations on others HL dimensions. These pattern offering concrete suggestions to tailor support to the needs of patients. In addition, we found that patients in the 7 subgroups differed significantly with respect to educational level, number and type of chronic diseases, severity of disability, living situation and the level of urbanity of their residence pointing to the importance of taking context factors into account when developing interventions to improve HL skills. For example, people with chronic illnesswho were living alone require more support with getting help from their social environment and finding and understanding health information compared with people we had a partner or children. While some subgroups might have a similar total score, the actions for improving their outcomes would differ.