Health Literacy and Early Physical Activity After Solid Organ Transplantation: A Prospective Observational Study.

BACKGROUND: Regular physical activity (PA) improves clinical outcomes and quality of life after solid organ transplantation, yet many recipients remain inactive during early recovery. Health literacy (HL) may influence posttransplant health behaviors. METHODS: In this prospective observational study, consecutive adult kidney, liver, and lung transplant recipients at the Centre hospitalier de l'Université de Montréal (CHUM) between March 1 and December 1, 2023 were assessed approximately two months after discharge. Functional HL was measured using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Weekly moderate to vigorous PA was assessed using face-to-face interview during outpatient visits and categorized according to World Health Organization recommendations (<150 vs. ≥150 min/week). Multivariable logistic regression evaluated the association between HL and PA, adjusting for age, sex, body mass index, history of depression and/or current antidepressant treatment, education level, and transplant type. RESULTS: Eighty-five recipients were included; Thirty-two patients were not eligible for inclusion (language barrier, re-transplantation, refusal, or death). Thirty-nine participants (45.8%) met recommended PA levels. Higher HL was independently associated with achieving PA recommendations (OR per 1-point increase: 1.09; 95% CI 1.02-1.17; p = 0.01). PA engagement was not associated with age, sex, education level, history of depression and/or current antidepressant treatment, or transplant type. CONCLUSIONS: Nearly half of recipients achieved guideline-recommended PA approximately two months after transplantation, indicating that meaningful activity is feasible during early recovery. Higher functional HL was independently associated with PA engagement, supporting the integration of literacy-sensitive approaches into posttransplant rehabilitation.