UC Merced

Understanding determinants of health behavior engagement is key to promoting health outcomes. One such determinant is health literacy, the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (Baker et al., 2006). In this study we aimed to meta-analyze the effect of health literacy on health behavior engagement and outcomes across studies. We conducted a systematic search of published and unpublished literature (k = 203) to examine the overall relationship between health literacy, health behaviors, and health outcomes as mediated by social cognition constructs (attitudes, self-efficacy, knowledge, and risk perceptions). Meta-analysis indicated significant correlations between model constructs, particularly health literacy with knowledge and well-being, between self-efficacy and knowledge, attitudes, risk perceptions, and health behavior, and between risk perceptions and attitudes. A structural equation model based on the synthesized correlations indicated that self-efficacy and attitudes mediated the relationship between health literacy and health behavior. There were also total indirect effects of social cognition constructs on the health literacy-health behavior relationship. Analysis of health literacy measure type, sample origin, and behavior type revealed few differences in model results. Findings support that health literacy is associated with health behavior engagement, and this relationship may be explained by various health beliefs. Understanding the effects of health literacy or health beliefs on health behaviors may potentially be informative for future research aiming to promote health outcomes broadly.