{
  "abstract": "Objective: Multicenter evidence comparing health literacy across Spanish autonomous communities in primary care remains scarce. We aimed to describe health literacy among adults attending scheduled nursing consultations and explore sociodemographic, clinical, and territorial differences.\n\nMethods: Multicenter cross-sectional study in primary care health centers of six Spanish autonomous communities, conducted between June 2025 and January 2026. Adults aged 18–75 years (n = 980) completed the 16-item European Health Literacy Survey Questionnaire, Ponte a 100 lifestyle questionnaire, and 13-item Orientation to Life Questionnaire. Non-parametric tests and multiple linear regression were used.\n\nResults: Among 920 participants with valid scores, 62.50% presented sufficient health literacy and 37.50% problematic or inadequate health literacy. Health literacy was largely homogeneous across sociodemographic groups. Older age was weakly associated with lower health literacy, whereas chronic disease and sense of coherence were associated with higher health literacy; lifestyle was not retained. Participants from Castilla-La Mancha and Castilla y León showed slightly lower adjusted health literacy scores. The model explained 9.50% of health literacy variability.\n\nConclusions: Sufficient health literacy predominated, but more than one third of participants had limited health literacy, and territorial differences were small. Contextual and healthcare-related factors may shape health literacy beyond individual characteristics.",
  "abstract_shown": true,
  "affiliations": [
    "Medical Oncology Clinical Trials Unit, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain",
    "UCM Research Group \"Public Health – Lifestyles, Nursing Methodology and Care in the Community Setting\", Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain",
    "Family and Community Care Specialist Nurse, Nursing Manager at José Luis Santamaría Health Centre, Burgos, Spain",
    "Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Albacete, Spain",
    "Institute for Health Research of Castilla-La Mancha (IDISCAM), Albacete, Spain",
    "Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS-(RICORS), ISCIII, Spain",
    "Primary Health Care, La Palma Health Services, The Canary Islands Health Service, 38713 Breña Alta, Spain",
    "Nursing Department, Healthcare Sciences School, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain",
    "Primary Health Care, Tenerife Primary Health Care Services, The Canary Islands Health Service, 38005 Tenerife, Spain",
    "Nursing Department, Faculty of Nursing, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain",
    "INVESTIC Translational Care Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain",
    "Meixoeiro University School of Nursing, UVIGO, 36214 Vigo, Galicia, Spain",
    "Care Research Unit, Vigo Health Area, Álvaro Cunqueiro Hospital, SERGAS, Spain",
    "Family and Community Care Specialist Nurse. Manager of San Roque Health Centre. Badajoz. Extremadura Health Service, Spain",
    "Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Spain",
    "Health Research Institute 12 de Octubre Hospital (Imas12), 28041 Madrid, Spain"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "David García-García"
    },
    {
      "affs": [
        2
      ],
      "name": "Andrea González-Ayala"
    },
    {
      "affs": [
        3,
        4,
        5
      ],
      "name": "Cristina María Lozano-Hernández"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Martín Rodríguez-Álvaro"
    },
    {
      "affs": [
        5,
        8,
        9
      ],
      "name": "Pedro Ruymán Brito-Brito"
    },
    {
      "affs": [
        10,
        11,
        12
      ],
      "name": "Macarena Chacón-Docampo"
    },
    {
      "affs": [
        13
      ],
      "name": "María Gil-Marchena"
    },
    {
      "affs": [
        1,
        14,
        15
      ],
      "name": "Francisco Javier Pérez-Rivas"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/16am7y0hmxfj8.bib",
  "cited_by": 0,
  "doi": "10.1016/j.pmedr.2026.103677",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13734806/",
  "id": "16am7y0hmxfj8",
  "issns": [
    "2211-3355"
  ],
  "landing_url": "https://doi.org/10.1016/j.pmedr.2026.103677",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Infectious Disease"
    ],
    [
      "openalex",
      "3600|Health Literacy and Information Accessibility"
    ]
  ],
  "openalex": "W7223405488",
  "pdf_url": null,
  "pmcid": "PMC13734806",
  "pmid": "42990573",
  "published": "2026-10-23",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/16am7y0hmxfj8.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:20:37Z",
      "native_id": "PMC13734806",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.pmedr.2026.103677"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Infectious Disease",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Health literacy in primary care users from six Spanish autonomous communities: a multicenter study of territorial variation",
  "title_text": "Health literacy in primary care users from six Spanish autonomous communities: a multicenter study of territorial variation",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:20:37Z",
  "url": "https://research.draconitic.com/paper/16am7y0hmxfj8",
  "venue": "Preventive Medicine Reports",
  "versions": []
}