An empirical test of the Health Empowerment Model: Does patient empowerment moderate the effect of health literacy on health status?

Objective: The Health Empowerment Model (Schulz & Nakamoto, 2013) advocates that the effects of health literacy and empowerment are intertwined on health outcomes. This study aims to test this assumption in the context of health status as a patient outcome. Methods: A cross-sectional study was conducted with a sample of 302 participants between June and December 2015. The participants’ health literacy (using the NVS and S-TOFHLA tests), empowerment and self-reported health status were assessed. Results: The participants having a high level of patient empowerment and concurrent adequate health literacy (the so-called ‘effective self-managers’) reported better health status compared to patients who had either lower health literacy and/or lower empowerment scores (P < 0.05). Moreover, the meaningfulness (b = 0.053, t(297) = 2.29, P = 0.02) and competence (b = 0.07, t(297) = 2.47, P = 0.01) sub-dimensions of patient empowerment moderated the effect of the NVS on current health status. Conclusion: The study provides evidence for the independence of health literacy and empowerment and partial evidence for their interaction predicting health status. Practice implications: Our findings highlight that health literacy and patient empowerment (in particular its competence and meaningfulness sub-facets) are crucial patient-related variables, to be taken into consideration simultaneously, during screening and health promotion campaigns fostering health status in the general population.