Health literacy and work ability in employees with health-related risk factors within a structural model

BACKGROUND: Health literacy and work ability are both becoming increasingly important as concepts in health promotion. Since health literacy is considered an individual resource for health, which in turn is the basis for good work ability, this is especially the case for employees who already show health-related risk factors. Therefore, the question arises as to what extent health literacy skills have an impact on work ability in this group of employees.

OBJECTIVES: The aim of this study was to examine the associations between the six constructs of Lenartz' structural health literacy model (perceptive-motivational conditions: "self-perception", “proactive approach to health”, behavioural components: "dealing with health information", "self-control", "self-regulation", "communication and cooperation") and the work ability among employees with health-related risk factors.

METHODS: The present evaluation was based on baseline data of a cross-provider workplace-related intervention (158 employees with health-related risk factors, 53.8% women, 48±10 years). Health literacy was assessed with Lenartz’s Health Literacy Questionnaire and work ability was measured by the German Short Form of the Work Ability Index (WAI). The associations were examined using structural equation modelling with partial least squares (SmartPLS 2.0.M3).

RESULTS: Model’s reliability, validity, and structure could be verified. “Self-regulation” showed the only statistically significant direct effect on work ability (ß=0.32, t(∞)=4.00, p<0.01, f²=0.09), while in addition “self-perception” had a significant indirect effect (ß=0.13, t(∞)=2.53, p<0.05). The model explained 17.5% of the WAI score variance.

CONCLUSIONS: The structural model offers promising approaches in terms of designing target group-specific interventions. In employees with health-related risk factors, self-regulation and self-perception should be encouraged. However, additional resources and conditions influencing work ability should be considered.