Evidence map›Paper›PMID 40728721›Full record

ArticleHeart and vessels2026

Low health literacy limits behavioral changes during phase I cardiac rehabilitation: a multicenter clinical study.

Yuji Kanejima, Kazuhiro P Izawa, Masahiro Kitamura, Kodai Ishihara, Asami Ogura, Ikko Kubo, Hitomi Nagashima, Hideto Tawa, Daisuke Matsumoto, Ikki Shimizu

Abstract readClinical StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Heart and vessels, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Yuji KanejimaDepartment of Public Health, Graduate School of Health Sciences, Kobe University, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-ku, Kobe, 654-0142, Japan.
Kazuhiro P IzawaDepartment of Public Health, Graduate School of Health Sciences, Kobe University, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-ku, Kobe, 654-0142, Japan. izawapk@harbor.kobe-u.ac.jp.ORCID http://orcid.org/0000-0001-7262-8903
Masahiro KitamuraDepartment of Public Health, Graduate School of Health Sciences, Kobe University, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-ku, Kobe, 654-0142, Japan.
Kodai IshiharaDepartment of Public Health, Graduate School of Health Sciences, Kobe University, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-ku, Kobe, 654-0142, Japan.
Asami OguraDepartment of Public Health, Graduate School of Health Sciences, Kobe University, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-ku, Kobe, 654-0142, Japan.
Ikko KuboDepartment of Public Health, Graduate School of Health Sciences, Kobe University, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-ku, Kobe, 654-0142, Japan.
Hitomi NagashimaDepartment of Rehabilitation, Shinyukuhashi Hospital, Yukuhashi, Japan.
Hideto TawaDepartment of Cardiology, Sanda City Hospital, Sanda, Japan.
Daisuke MatsumotoDepartment of Cardiovascular Medicine, Yodogawa Christian Hospital, Osaka, Japan.
Ikki ShimizuDepartment of Diabetes, Sakakibara Heart Institute of Okayama, Okayama, Japan.

Funding

Japan Society for the Promotion of Science JP22K11392Japan Society for the Promotion of Science JP23K16629
6 · The paper itself

Abstract

Cardiovascular diseases are strongly associated with poor lifestyle habits. Adopting healthier lifestyle habits is essential for reducing the risks associated with cardiovascular diseases. However, low health literacy (HL) may compromise assessing, using, and understanding health information, making modification of health behavior less likely. This study aimed to clarify the relationship between HL and changes in health behavior in inpatients undergoing cardiac rehabilitation. This was a multicenter cohort study of patients undergoing phase I cardiac rehabilitation. We used the 14-item Health Literacy Scale (HLS-14) to assess HL and the transtheoretical model (TTM) to assess changes in health behavior. Behavioral changes during hospitalization were defined using the stages of the TTM. A total of 428 patients who underwent cardiac rehabilitation (mean age: 73.0 years; males: 71.5%) were included. Evaluation of the behavioral changes exhibited by the participants revealed that the pre-contemplation stage (83.2%) was common at the beginning of rehabilitation, whereas contemplation (50.7%) and preparation (38.1%) stages were common at discharge. Of the 428 participants, 83.6% exhibited behavioral changes during hospitalization. Multivariate analysis revealed that HLS-14 score was a significant explanatory variable associated with changes in health behavior (odds ratio: 1.04; 95% confidence interval: 1.00-1.07). The spline curves modeling the relationship between HLS-14 score and changes in health behavior showed a positive correlation in the low HL group. HL is significantly correlated with changes in health behavior, especially in individuals with a low HL level.

Indexed as

Cardiac RehabilitationCardiovascular DiseasesHealth BehaviorHealth Knowledge, Attitudes, PracticeHealth LiteracyAgedAged, 80 and overFemaleHumansJapanMaleMiddle AgedBehavioral changesCardiac rehabilitationCohort studyHealth literacyTranstheoretical model

Identifiers

PMID40728721
PMCPMC12795910

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.