## 4 Discussion  
The sociodemographic profile of informal caregivers in this study largely aligns with the existing literature, particularly concerning sex, age, employment status, education level, and their relationship with the dependent child. \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Health Literacy Domain** & **S0** & **S1** & **S2** \\  & **Mean (sd)** & **Mean (sd)** & **Mean (sd)** \\ \hline Global health literacy & 30.36 (6.93) & 37.19 (4.98) & 43.14 (4.98) \\ Healthcare & 25.77 (9.80) & 34.10 (8.51) & 40.80 (6.26) \\ Disease prevention & 34.51 (8.16) & 38.73 (7.29) & 45.06 (5.95) \\ Health promotion & 33.21 (10.23) & 40.69 (6.89) & 44.83 (6.17) \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Mean scores of health literacy for each domain, at three evaluation stages. \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Health Literacy Levels** & **S0** & **S1** & **S2** \\  & **N (\%)** & **N (\%)** & **N (\%)** \\ \hline Inadequate & 7 (20.6\%) & - & - \\ Problematic & 15 (44.1\%) & 7 (20.6\%) & 1 (3.4\%) \\ Sufficient & 10 (29.4\%) & 23 (67.6\%) & 11 (37.9\%) \\ Excellent & 2 (5.9\%) & 4 (11.8\%) & 17(58.6\%) \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Health literacy levels at three evaluation stages. \begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Literacy (I)** & **Literacy (J)** & \
\begin{tabular}{c} **Mean** \\ **Difference (I - J)** \\ \end{tabular} &
\begin{tabular}{c} **Standard** \\ **Deviation** \\ \end{tabular} & **Sig.** \\ \hline S0 & S1 & \(-\)6.36 & 1.028 & \(<\)0.001 \\  & S2 & \(-\)12.21 & 1.092 & \(<\)0.001 \\ \hline S1 & S0 & 6.36 & 1.028 & \(<\)0.001 \\  & S2 & \(-\)5.86 & 0.845 & \(<\)0.001 \\ \hline S2 & S0 & 12.21 & 1.092 & \(<\)0.001 \\  & S1 & 5.86 & 0.845 & \(<\)0.001 \\ \hline \hline \end{tabular}
\end{table} 
Table 5: Comparison of HLS-EU-Q16 scores between the three evaluation stages (based on estimated marginal means). This study found that 71% of informal caregivers were women, consistent with the literature indicating that caregiving is a highly gendered activity [28; 29; 30; 31; 32; 33]. Despite universal care needs and various gender equality initiatives, the distribution of caregiving tasks remains disproportionate. Society continues to assign and associate the caregiving role primarily with women [28; 33]. This disparity acts as a barrier to gender equality and negatively impacts women's employment opportunities, especially at younger ages. Notably, 50% of women in this study remained employed while providing informal care, mirroring findings in both Portuguese and other European populations [28; 31; 32; 33]. While most reviewed studies report caregiver age in broad ranges (typically between 35 and 64 years [29; 30; 31; 32; 33]), the mean age of participants in this study was 41.06 \(\pm\) 4.98 years, falling in this range. Participants also showed a similar distribution between secondary and higher education levels, consistent with data from the Caring for Informal Caregivers Movement study [32]. We observed that the dependent individuals were minors with an average age of 9 years, predominantly cared for by their parents, an observation consistent with other studies [30; 32]. Our intervention was designed to foster greater awareness of physical and emotional well-being among caregivers through their participation in activities. They learn practical self-care strategies (such as energy conservation techniques and proper posture) and strengthen their ability to understand, apply, and share health information within a group dynamic. This hands-on experience directly empowers caregivers to make informed decisions for themselves and in the context of the care they provide. As [PERSON] et al. [15] highlight, physical activity significantly impacts mental health by reducing anxiety and depression, boosting self-esteem, and improving overall mood and well-being. These positive effects create a more receptive state for acquiring new knowledge and developing cognitive and emotional skills essential for health literacy.