Improving quality by involving patient. The role of health literacy in influencing patients’ behaviors

Health services’ quality relies on patients’ participation in the design and delivery of care. Inter alia, self-efficacy and awareness are paramount to realize the full potential of health services’ co-production. This paper investigates the effects of health literacy – i.e. the ability to access, understand, process, and use health information – on individual self-efficacy perceptions and awareness. A random sample of 591 Italian patients was built. The Newest Vital Sign (NVS) screening tool was used to measure individual health literacy skills; moreover, a self-reporting survey was designed to assess: (1) self-efficacy perceptions; (2) awareness; and (3) health services’ use. A multivariate regression model was used to investigate the relationship between these variables. Limited health literacy was found to be prevailing. The lower the respondents’ health literacy skills, the poorer their self-efficacy perceptions and the smaller their awareness of health-related issues. Inadequate health literacy triggered lower patient involvement and greater risks of inappropriate access to care. Inadequate health literacy performs as a barrier to health services’ co-production. Therefore, a special health literacy concern should be attached to health policies aimed at promoting patient involvement.