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Women Health. 2018 Jul;58(6):632-646. doi: 10.1080/03630242.2017.1333074. Epub 2017 Jul 6.

Health-related behaviors moderate the association between age and self-reported health literacy among Taiwanese women.

Author information

a College of Public Health and Nutrition , Taipei Medical University , Taipei , Taiwan.
b Department of Environmental Health Sciences , National Health Research Institute , Miaoli , Taiwan.
c Asian Health Literacy Association , Geneva , Switzerland.
d Global Health Literacy Academy , Urmond , Netherlands.
e Health Promoting Hospitals, WHO-CC Health Promotion in Hospitals and Health Care and University of Vienna , Vienna , Austria.
f Faculty of Psychology and Educational Sciences , Université Catholique de Louvain , Louvain-la-Neuve , Belgium.
g School of Public Health , National Yang Ming University , Taipei , Taiwan.
h Department of Family Medicine , Shuang Ho Hospital , Taipei , Taiwan.
i Department of Healthcare Management , Yuanpei University of Medical Technology , Hsin-Chu , Taiwan.
j Department of Family Medicine , Taipei Hospital, Ministry of Health and Welfare , Taipei , Taiwan.


The role of health-related behaviors in the association between age and health literacy has not been well-elucidated. The present cross-sectional study evaluated the interactions between age and health-related behaviors in 942 women in Taiwan between February and October 2013. Women aged 18-78 years were randomly sampled and recruited from the national administrative system. Self-reported health literacy was measured by the European Health Literacy Survey Questionnaire (HLS-EU-Q47) in Mandarin, asking about sociodemographics and essential health-related behaviors (watching health-related television, community involvement). The interviews were conducted confidentially by well-trained interviewers after having participants' consent. In multiple linear regression models adjusted for education attainment, self-perceived social status, ability to pay for medication, and health-related behaviors, health literacy was significantly negatively related to age (unstandardized regression coefficient, B = -0.04; 95% confidence interval [CI] = (-0.07; 0.00); p = .03). The lower health literacy among older women was significantly modified by watching health-related television programs (from "rarely/not-at-all", B = -0.08 (-0.12, -0.04), p < .001 to "often"; B = 0.10 (0.07, 0.12); p < .001) and community involvement (from "rarely/not-at-all", B = -0.06 (-0.10, -0.03); p = .001 to "often", B = 0.06 (0.03, 0.08); p < .001). Specific health behaviors were protective of older women's health literacy and likely their health.


Age; community involvement; health literacy; health-related television; women

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