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. (c) 2017 Elsevier B.V. All rights reserved.
