title: Functional, interactive and critical health literacy: Varying relationships with control over care and number of GP visits.
abstract: OBJECTIVE
  The aim of this study is to examine the extent to which functional, interactive and critical health literacy are associated with patients' perceived control over care and frequency of GP visits.
  
  
  METHODS
  Data from the Dutch 'National Panel of People with Chronic Illness or Disability' was used (N=2508). Health literacy was assessed by the Functional, Communicative and Critical Health Literacy measure. Perceived control over care was indicated by perceived ability to organize care, interact with providers and to perform self-care. By multivariate linear and logistic regression analyses, associations between health literacy and perceived control over care and subsequently frequency of GP visits were studied.
  
  
  RESULTS
  Mainly interactive health literacy was associated with patients' perceived ability to organize care, interact with healthcare providers and perform self-care, whereas only functional health literacy was associated with number of GP visits.
  
  
  CONCLUSIONS
  The results imply that some patients' may be less able to exert control over their care because of lower health literacy. Functional, interactive and critical health literacy vary in their relevance for patients' ability to exert control.
  
  
  CONCLUSIONS
  Initiatives for strengthening patients' role in healthcare may be improved by paying attention to patients' health literacy, specifically functional and interactive health literacy.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, Netherlands. Electronic address: i.vanderheide@nivel.nl.
authors.forename: Iris
authors.initials: I
authors.lastname: van der Heide
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Heijmans
authors.affiliation: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands; Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, Netherlands.
authors.forename: A Jantine
authors.initials: AJ
authors.lastname: Schuit
authors.affiliation: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
authors.forename: Ellen
authors.initials: E
authors.lastname: Uiters
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, Netherlands.
authors.forename: Jany
authors.initials: J
authors.lastname: Rademakers
mesh_terms: D001294:Attitude to Health; D002908:Chronic Disease; D003142:Communication; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D058005:General Practitioners; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D016015:Logistic Models; D008297:Male; D009426:Netherlands; D009819:Office Visits / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D012648:Self Care
keywords: Health literacy; Healthcare use; Interaction; Organization of care; Patient control over care; Self-care