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Health Education & Behavior
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Article

Health Literacy and Health Actions: A Review and a Framework From Health Psychology

Christian von Wagner, PhD1*, Andrew Steptoe, DSc2, Michael S. Wolf, PhD3, and Jane Wardle, PhD1

1 University College London, Department of Epidemiology and Public Health, Health Behaviour Research Centre
2 University College London, Department of Epidemiology and Public Health, Psychobiology Unit
3 Health Literacy and Learning Program, Institute for Healthcare Studies, Feinberg School of Medicine at Northwestern University, Chicago, Illinois

* To whom correspondence should be addressed. E-mail: c.wagner{at}ucl.ac.uk.


  Abstract
The association between performance on health literacy measures and health outcomes is well established. The next step is to understand the processes through which health literacy affects health. This review introduces a framework drawing on ideas from health psychology and proposing that associations between health literacy and health outcomes could be mediated by a range of health actions involving access and use of health care, patient–provider interactions, and the management of health and illness. The framework outlines routes through which health literacy might affect either health actions themselves or the motivational and volitional determinants that have been identified in social cognition models. The implications of the framework for future research and intervention strategies are discussed.

First published on August 26, 2008, doi:10.1177/1090198108322819

Health Education & Behavior 2009;36:860.

A more recent version of this article appeared on October 1, 2009

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