Seeking information regarding one’s health is a fundamental process that drives individuals to make health-related choices. Possessing and understanding a wealth of information about self-care and disease prevention can help individuals make informed choices and improve their health goals.

Health literacy (HL) is the ability of individuals, families, and communities to make healthy health decisions in the context of everyday life (Lorini et al. 2019).

The term HL was first proposed in the 1970s and was a concept originally limited to functional skills such as reading, writing and basic literacy, elements necessary to understand information related to one’s health. Over the past two decades, increasing attention has been paid to the concept of HL given the significant benefits to public and individual health and to the sustainability of healthcare systems (Hesselink et al. 2022; Qi et al. 2021; Nutbeam and Lloyd 2021).

The concept of HL has been expanded to make the individual an active participant within modern healthcare systems: it is a true health strategy, the potential of which is to develop or improve the ability of individuals to access information and services and use them effectively, not only for their own health but also for all of the community (WHO 2023).

Increasingly, a relevant topic is mental HL, the knowledge and ability to promote mental health and reduce the impact of mental illness (Queensland Mental Health Commission 2023).

Several studies, particularly on adolescents, have been conducted on this topic, in the conviction that increasing these capacities increases the mental potential of the individual (Lai et al. 2016; Petersen et al. 2024; Jansson et al. 2024).

The importance of this issue is emphasized by the World Health Organization (WHO) within the health promotion glossary and concretized by the launch of a European “Network on Measuring Population and Organization Health Literacy (MPHOL)” program, founded under the auspices of WHO’s European Health Information Initiative (EHII), in February 2018. The main objective was to generate population and HL data to support evidence-based policy decisions and interventions. The ultimate goal of this project aims to provide learning opportunities for people to be able to improve their HL and enhance investments in developing more transparent and user-friendly systems for those with limited personal HL (Istituto Superiore di Sanità 2023).

The Health Literacy Survey Project 2019–2021 (HLS19) is the first project of M-PHOL, whose 17 participating countries—Austria, Belgium, Bulgaria, Czech Republic, Denmark, France, Germany, Hungary, Ireland, Israel, Italy, Norway, Portugal, Russian Federation, Slovakia, Slovenia, and Switzerland—had the goal of measuring population HL through an international database to get a comprehensive view of HL within the member states of the WHO European region (M-POHL 2019a, b).

M-PHOL, with the HLS19 project, developed a main instrument, the HLS19-Q47, a time-consuming questionnaire for research, thus giving rise to two short modules, the HLS19-Q16 and the HLS19-Q12, to measure general HL (M-POHL 2019a, b).

The two questionnaires, initially validated in seven different languages (English, Bulgarian, Dutch, German, Greek, Polish, and Spanish), were followed by a study conducted in Florence, Italy, which provided positive results regarding the reliability of the HLS-EUQ16 and the HLS-EUQ6 instruments translated into Italian versions (Lorini et al. 2019).

The results and recommendations of the Health Literacy Survey (HLS19) 2019–2020 of WHO show that, in the European overview, respondents with limited HL fluctuate by country between 25 and 72%. Factors affecting good HL are many, and among the most influential situations associated with lower literacy is that of being financially destitute. This condition, combined with the others, triggers a vicious cycle through which the individuals have a lower perception of themselves and the health problems that affect or surround them, leading to an increase in long-term health problems (Pelikan et al. 2021).

HL is a current, central, and no longer procrastinable issue. Regular HL measurement and evaluation interventions are critical to closing the HL gap among the population and in countries worldwide. All HCW need to be involved in this process, and to be able to take part in it effectively, they have to possess solid skills. The aim of this study, an explorative research without any a priori hypotheses, is to evaluate HL score in healthcare workers in some hospitals in Rome.