Objectives Given the persistent, complex, and diverse health needs of chronic disease patients, their health literacy and active participation in the process of primary health service delivery has gained increasing attention. This study aimed to identify the potential profiles of patient health literacy, examine the sociodemographic and health factors associated with these profiles, and investigate the relationship between health literacy profiles and patient participation in primary health care.

Methods A cross-sectional survey was conducted in Shandong Province, China, from July 14 to August 20, 2023. 911 patients with chronic diseases were selected using a multistage stratified sampling method. The survey assessed sociodemographic and health characteristics, patient health literacy, and patient participation. We adopted latent profile analysis (LPA) to identify the categories of patient health literacy, and multiple linear regression was performed to assess the impact of health literacy profiles on patient participation.

Results Three distinct latent profiles were identified: low health literacy group (Profile 1,10.98%), moderate health literacy group (Profile 2, 56.86%), and high health literacy group (Profile 3, 32.16%). Age, marital status, residency, occupational status, education level, personal monthly income, and health status had statistically significant effects on patient health literacy profiles (P<0.05). Patients with higher health literacy exhibited significantly greater participation in primary health care than those with lower health literacy (B = 3.544, p < 0.001).

Conclusions This study’s findings highlight the heterogeneity of health literacy among patients with chronic diseases and underscore the need for tailored interventions to enhance patient health literacy. In addition, the findings offer valuable insights for enhancing health literacy in facilitating patient participation in primary health care.

The authors have declared no competing interest.

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the Ethics Committee of Binzhou Medical University

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