ArticlePatient preference and adherence2026
The Mediating Role of Treatment Adherence in the Relationship Between Health Literacy and Health Maintenance Efficacy Among Adults with Type 1 Diabetes.
Article in Patient preference and adherence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Health literacy is a key determinant of diabetes self-management; however, the behavioral mechanisms linking health literacy to health maintenance efficacy in adults with type 1 diabetes mellitus (T1DM) remain insufficiently explored. Health maintenance efficacy refers to individuals' perceived ability to sustain long-term diabetes care behaviors. Methods: This cross-sectional analytical study was conducted with 368 adults diagnosed with T1DM in Turkey. Data were collected online using the European Health Literacy Survey Questionnaire (HLS-EU-Q6) and the treatment adherence and health maintenance efficacy subscales of the Chronic Illness Self-Management Scale. Descriptive statistics, Pearson correlation analysis, and mediation analysis were performed using Hayes' PROCESS Model 4 with 5000 bootstrap resamples. Results: Health literacy was positively associated with both treatment adherence and health maintenance efficacy. Treatment adherence played a partial mediating role in the association between health literacy and health maintenance efficacy (indirect effect = 0.11; 95% CI: 0.06-0.17). The final model explained 38% of the variance in health maintenance efficacy. Conclusion: Health literacy was strongly associated with health maintenance efficacy in adults with T1DM, both directly and indirectly through its association with treatment adherence. By conceptualizing health maintenance efficacy as a distinct construct reflecting the sustainability of diabetes care behaviors, the findings provide clearer insight into how health literacy relates to long-term self-management capacity. Given the cross-sectional design, these relationships should be interpreted as associative rather than causal.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.