Mediating effect of dietary self-efficacy in the relationship between health literacy and nutrition label use among coronary heart disease patients

Nutrition label use among patients with coronary heart disease (CHD) is limited. This study aims to investigate the mediating effect of dietary self-efficacy on the relationship between health literacy and nutrition label use in CHD patients. This cross-sectional study recruited 350 CHD patients using convenience sampling from two hospitals in Changsha City. Data were collected using a general information questionnaire, the Newest Vital Sign Scale, the Cardiac Diet Self-efficacy Scale, and the Nutrition Label Use Questionnaire. SPSS 25.0 was used for Pearson correlation analysis and multiple linear regression analysis, while Model 4 in the SPSS macro program PROCESS was applied for mediation effect analysis. The results indicated health literacy and dietary self-efficacy were positively and significantly correlated with nutrition label use in CHD patients (P < 0.001). Bootstrap test results demonstrated that dietary self-efficacy partially mediated the relationship between health literacy and nutrition label use, with a mediation effect of 0.184 (95% CI: 0.144-0.225), accounting for 55.42% of the total effect. In conclusion, dietary self-efficacy mediates the relationship between health literacy and nutrition label use in CHD patients. Targeted interventions that address both health literacy and dietary self-efficacy are crucial for improving nutrition label use among CHD patients.