Health literacy among people with systemic sclerosis: a scleroderma patient-centred intervention network (SPIN) cohort cross-sectional study.

OBJECTIVE

Health literacy reflects the ability to find, understand, evaluate, and use information to make health-related decisions. We evaluated sociodemographic and disease factors associated with health literacy among people with systemic sclerosis (SSc).

METHODS

Participants with SSc in the Scleroderma Patient-centred Intervention Network Cohort completed the Health Literacy Scale19-12 Item Questionnaire from February to November 2025. Multivariable linear regression was used to assess associations of sociodemographic and disease characteristics with health literacy.

RESULTS

The 1,019 participants were mainly female (N = 898, 88%) and White (N = 850, 84%). Mean (SD) years of education was 15.5 (3.9). Most had limited cutaneous SSc (N = 669, 66%). Mean health literacy total score was 69.7; 438 (43%) participants had excellent or sufficient and 581 (57%) had problematic or inadequate health literacy. Education (1.63 points per 5 years, 95% CI 0.25 to 3.01) was significantly associated with higher health literacy scores. Compared to the United States, participants from Canada (-4.98 points, 95% CI -7.99 to -1.97), the United Kingdom (-7.79 points, 95% CI -12.03 to -3.55), France (-6.05 points, 95% CI -8.84 to -3.27), and Australia, Mexico, or Spain (-7.02 points, 95% CI -12.39 to -1.66) had significantly lower health literacy scores. Age, gender, race or ethnicity, marital status, time since first non-Raynaud symptom onset, and disease subtype were not associated with health literacy.

CONCLUSION

The association between health literacy and education was small. Differences between countries may reflect self-evaluation tendencies. More work is needed to better understand health literacy measurement.