Interventions to improve health literacy among Aboriginal and Torres Strait Islander Peoples: a systematic review

Simone Nash,Amit Arora

doi:10.1186/s12889-021-10278-x

Abstract

BackgroundAboriginal and Torres Strait Islander peoples continue to experience poorer health outcomes than other population groups. While data specific to Indigenous Australians are scarce, a known social health literacy gradient exists linking low health literacy and poor health outcomes within many minority populations. Improving health literacy among Indigenous Australians is an important way to support self-determination and autonomy in both individuals and communities, by enhancing knowledge and improving health outcomes. This review aims to rigorously examine the effectiveness of health literacy interventions targeting Aboriginal and Torres Strait Islander peoples.MethodsA systematic review across six databases (The Cochrane Library, PubMed, Embase, SCOPUS, ProQuest Dissertation and Thesis and Web of Science) was performed for publications evaluating interventions to improve health literacy among Indigenous Australian adults using search terms identifying a range of related outcomes.ResultsOf 824 articles retrieved, a total of five studies met the eligibility criteria and were included in this review. The included studies evaluated the implementation of workshops, structured exercise classes and the provision of discounted fruit and vegetables to improve nutrition, modify risk factors for chronic diseases, and improve oral health literacy. All interventions reported statistically significant improvement in at least one measured outcome. However, there was limited involvement of the Aboriginal and Torres Strait Islander community members in the research process and participant retention rates were sub-optimal.ConclusionThere is limited evidence on interventions to improve health literacy in Indigenous Australian adults. Participation in interventions was often suboptimal and loss to follow-up was high. Future studies co-designed with Aboriginal and Torres Strait Islander community members are needed to improve health literacy in this population.

Highlights

Aboriginal and Torres Strait Islander peoples continue to experience poorer health outcomes than other population groups
Discounting fruits and vegetables by 20% to help protect against obesity and diet-related disease is partially effective The effects of fiscal interventions can be enhanced by the use of creative merchandising techniques and consumer education The intervention was partially effective in increasing consumption of fruits and vegetables among the target population, but was not strong enough to overcome mediators and moderators affecting lasting behaviour change
The intervention was found to be partially successful in improving oral health literacy and oral health

Summary

Introduction

Aboriginal and Torres Strait Islander peoples continue to experience poorer health outcomes than other population groups. Improving health literacy among Indigenous Australians is an important way to support self-determination and autonomy in both individuals and communities, by enhancing knowledge and improving health outcomes. Health literacy encompasses all the skills which contribute to the ability to live a healthful life [3] In this respect, health literacy is recognised as an important factor that involves the patient/ consumers’ and the individuals/organisations involved in the provision of care [6]; but is a concept that pertains to broader societal health practice and the ways in which health information is sought and shared among population groups (distributed health literacy) [7, 8]

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