ssociation between health literacy and reproductive health knowledge and behavior : A cross-sectional survey among women of reproductive age in Vienna.

OBJECTIVE: Despite Austria's highly ranked healthcare system, health literacy (HL) is lower than in other European countries, with Vienna falling below the national average in life expectancy and healthy life years. Following the 2016 WHO Strategy for Women's Health and Well-being, Austria introduced a Women's Health Action Plan in 2017, which highlighted a major lack of information about women's reproductive health. To date, data on reproductive health knowledge (RHK) and behavior (RHKB), and their relationship with HL remain scarce. The study aimed to examine these relationships among women in Vienna. METHODS: An online cross-sectional survey was conducted in 2023 among women of reproductive age (18-49 years) in Vienna. Collected data included information about sociodemographic characteristics, HL (HLS19-Q12-AT), RHK and RHKB (0-100% scale). Associations between RHK/RHKB and HL, alongside sociodemographic characteristics were examined using linear regression analyses. RESULTS: Among 386 participating women 41% had limited HL. Mean scores were 71% (SD = 21) for HL, 74% (SD = 16) for RHK, and 78% (SD = 14) for RHKB. The highest rate of incorrect responses concerned egg cell lifespan (61%), human papillomavirus (HPV) consequences (49%) and fertility age (40%). In univariate analyses RHK and RHKB were positively associated with older age and partnership and negatively associated with inadequate HL and certain religious affiliations. The RHKB was further associated with university education and parenthood. Multivariate analyses confirmed age and religion as significant factors. CONCLUSION: Our study identified RHK gaps among women in Vienna, showed associations between RHKB and HL and highlighted the importance of information sources. Findings underline the need for targeted interventions to improve reproductive HL.