Self-efficacy, health literacy, and chronic disease self-management among South–South adult migrants

In the context of the growing global migration phenomenon, recognized as a social determinant of health, risk factors associated with migration can increase the risk of developing chronic noncommunicable diseases (NCDs) and hinder their self-management, especially in vulnerable populations. The purpose of this study was to analyze the mediating role of self-efficacy in the relationship between health literacy and self-management of NCDs in migrants. The study was non-experimental and cross-sectional. A total of 241 migrants diagnosed with NCDs and residing in five cities in Chile participated. Data collection was carried out through surveys applied between March 2024 and January 2025. These included a sociodemographic and clinical questionnaire, the Partners in Health scale to assess self-management, the General Self-Efficacy Scale, and the HLS-EU-Q16 questionnaire to measure health literacy. Pearson’s correlation analysis was used to assess correlations, while a simple mediation model was estimated to explore possible mediation effects. Positive and significant correlations were found between health literacy and self-efficacy (r = .33), literacy and self-management (r = .38), and between self-efficacy and self-management (r = .44). Self-efficacy acted as a significant mediator in the relationship between literacy and self-management, explaining 25.8% of the total effect. These results indicate a partial mediation, suggesting that although self-efficacy is an important pathway, other explanatory mechanisms may also play a role. Health literacy shows a direct relationship with the self-management of chronic noncommunicable diseases in migrants, where self-efficacy plays a mediating role. Therefore, it is suggested that health teams emphasize the strengthening of self-efficacy in this population, to compensate for the gaps in health literacy and promote more effective self-management practices against NCDs. This research seeks to provide theoretical foundations to guide health professionals in the design of intervention strategies focused on individual and community factors that favor effective self-management in migrants.