Cluster analysis of health literacy profiles of adults with chronic diseases

OBJECTIVES: This study aimed to identify patterns of health literacy among adults with chronic diseases and determine factors associated with each health literacy domain. METHODS: Using data from 600 adults with chronic diseases assessed with the Health Literacy Questionnaire (HLQ), hierarchical cluster analysis was conducted to identify clusters with similar health literacy patterns. The number of clusters were identified by coefficient distance in agglomeration schedule, standard deviation within each HLQ domain within each cluster is ≤ 0.6 and meaningful differences of HLQ domains between clusters. Multivariate analysis using generalised linear models with backward modelling technique were performed to test key variables associated with each HLQ domain. RESULTS: Participants had a mean age of 61.54 years (± 15.3); 45.7 % were females, 56.4 % lived in rural areas, and 82.4 % had less than 12 years of education. Six distinct health literacy profiles were identified, ranging from 26 to 227 individuals per group. Each cluster presented unique health literacy strengths and weaknesses. Higher health literacy was significantly associated with more than 12 years of education, higher family income, being under 65, living in urban areas, receiving care from spouses or children, and having a lower comorbidity index. CONCLUSIONS: These profiles provided valuable insights for hospital administrators, healthcare policymakers, and providers to understand groups needing additional support. PRACTICE IMPLICATIONS: It is crucial for healthcare settings and providers to increase awareness about health literacy and implement educational strategies to assist individuals with varying health literacy levels, especially underserved socioeconomic groups.