Effectiveness Of Health Literacy Interventions Research Articles

Addressing the effectiveness of health literacy programs within the Gulf Corporation Council: an integrative review.

Health literacy is an increasingly required need to help individuals, families and communities manage their health and health conditions. It is linked with better self-adherence to treatments, use of resources, access to care and overall reduced costs in healthcare. In the Gulf Cooperation Council (GCC), which comprises Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates, various health literacy programs are implemented across states to address people's unique and complex healthcare needs. This article aims to examine the current literature and assess the factors that influence the outcomes of health literacy programs within the GCC. An integrative review methodology has been conducted to pursue a comprehensive understanding of health literacy interventions in the GCC. This investigative approach was shaped by Whittemore and Knafl's framework (2005), which includes problem identification, literature search, data evaluation, data analysis and presentation. The literature on the effectiveness of health literacy interventions and the factors that shape them are notably limited worldwide and within the GCC region. This integrative review addresses this knowledge gap and highlights the significance of key themes such as sessions, evaluation and improvement in shaping health literacy outcomes within the GCC region. Through this integrative review, the three main themes of sessions, evaluation and improvement were identified as influencing the outcomes of health literacy programs within the GCC.

Effectiveness of health literacy interventions on the health outcomes of higher education students

Abstract Background Health literacy is relevant to the empowerment process of higher education students. It reduces their vulnerability in health decision making. Higher education institutions are planning, implementing, and evaluating health literacy interventions on a variety of topics and using a variety of methodologies in order to achieve health benefits for their participants. Benefits in disease prevention, health promotion and health care have been associated with health literacy interventions. A review was conducted to identify and synthesise evidence on the effectiveness of health literacy interventions delivered in academic settings on the health outcomes of higher education students. Methods A systematic review of the literature was conducted with research on the EBSCO Host-Research Databases platform. The methodology followed the PRISMA guidelines, and the protocol was registered with PROSPERO. Methodological appraisal of the studies was carried out according to the Joanna Briggs Institute appraisal tool. A thematic and narrative synthesis was carried out for literature synthesis. Results This review included 9 articles out of 154 identified. The health gains of health literacy interventions in academic settings were positive changes in mental health; attitudes, norms, and self-efficacy for condom use; emotional, social, and psychological wellbeing; subjective sleep quality, sleep latency, and habitual sleep efficiency; physical activity; and self-reported servings of fried foods. The educational or motivational health literacy interventions contributed to health promotion, disease prevention or healthcare. Conclusions The variety of health literacy interventions that are delivered in an academic setting contributes to positive changes in the health outcomes of students in higher education. Investing in the design and delivery of health literacy interventions is one way to reduce their health vulnerability and protect them from the threats. Key messages • When planning health literacy interventions, it is important to know what health benefits they bring. • Health literacy interventions in an academic setting are important for health outcomes.

Effectiveness of health literacy interventions on anxious and depressive symptomatology in primary health care: A systematic review and meta-analysis.

Affective disorders are a debilitating and very prevalent problem throughout the world. Often these are associated with the onset of comorbidities or a consequence of chronic diseases. Anxiety and depression are associated with poor social and personal relationships, compromised health. We aimed to synthesize evidence from studies measuring the impact of a health literacy (HL) intervention on the improvement of affective disorders. For this systematic review and meta-analysis, we searched PubMed/MEDLINE, Embase, Web of Science, Ibecs, Cuiden, Scielo, Science Direct and Dialnet for exclusively randomized controlled trial studies (RCTs) published between 1 Jan 2011, and 31 May 2022. The search terms employed were "health literacy," "health knowledge," "anxiety," "anxiety disorder," "depression," "depressive disorder," and "adult." The risk of bias assessment was performed using the Cochrane Collaboration Revised Risk of Bias tool (RoB2). We conducted random-effects meta-analyses and explored heterogeneity using meta-regression and a stratified survey. Of 2,863 citations found through the initial screening, 350 records were screened by the title and abstract for their themes and relevance. Finally, nine studies complied with the inclusion criteria for the meta-analysis. 66.66% of studies (n = 6) were rated as having a low risk of bias and 33.33% (n = 3) were judged to raise some concerns. The health literacy interventions were associated with -1.378 reduction in depression and anxiety questionnaires scores [95% CI (-1.850, -0.906)]. Low mood disorder scores are associated with better mental health and wellbeing. Our findings demonstrate that an HL intervention in relation to the symptoms associated with affective disorders improves the emotional state of patients in PHC, with a moderately positive effect in reducing depression and anxiety.

The Health Literacy Status and Its Role in Interventions in Iran: A Systematic and Meta-Analysis.

There are increasing calls for public health policies to realize the visions of a health literate society and health literacy on a global scale. However, there are still more gaps in what researchers recognize and what steps they should take to improve health literacy (HL) skills. This review aimed to measure the HL status of the Iranian population and the effect size of the underlying association between HL and other health outcomes, and to examine the effectiveness of HL interventions on improving the functional dimension of HL, self-efficacy, and health-promoting behaviors. All full text published articles written in English and Persian language were included from inception until January 2019, but the type of study is not limited. A total of 52 potentially relevant articles with data on 36,523 participants were included in this review. In the population with health conditions, the average HL score was 62.51 (95% CI: 59.95–65.08), while in the patient population, the HL score was 64.04 (95% CI: 60.64–67.45). Health literacy was positively and significantly correlated with self-care behaviors 0.42 (95% CI; 0.35–0.49), self-efficacy 0.35 (95% CI; 0.26–0.43), knowledge 0.50 (95% CI; 0.44–0.55), communication skills 0.33 (95% CI; 0.25–0.41), and health promotion behaviors 0.39 (95% CI; 0.35–0.44). The meta-analyses showed that overall, HL interventions significantly improved HL status, self-efficacy, and health promotion behaviors. Results indicate that HL status was in the range of marginal HL level in the Iranian population. Our finding highlights the beneficial impact of HL intervention on health-promoting behaviors and self-efficacy, particularly in low literacy/socioeconomic status people.

Health education interventions to promote health literacy in adults with selected non-communicable diseases living in low-to-middle income countries: A systematic review and meta-analysis.

Health illiteracy is an important contributor to the burden of non-communicable diseases (NCDs); in particular in settings where health illiteracy is part of a perpetuating system of risk factors. Interventions that promote health literacy may provide an important tool in the primary and secondary prevention of NCDs. The objective of this systematic review was to evaluate the effectiveness of health literacy interventions on health literacy in the management of patients with selected NCDs living in low-to-middle income countries (LMIC). Seven electronic databases were searched (October 29, 2020) for RCTs aimed at improving health literacy in adults with NCDs in LMICs. Eligible NCDs included those pertaining to cancer, cardiovascular disease (CVD), chronic respiratory disease (CRD) or Diabetes. Studies were included that explicitly focussed on improving health literacy, and reported comprehensive measures of health literacy, or components thereof (ie, knowledge, attitude or behaviour). Random-effect meta-analyses were conducted for continuous outcome measures (Hedges-g). The completed search yielded 2573 unique results of which 53 unique studies met the inclusion criteria. Studies included patients with cancer (n=1, 2%), CRD (n=8, 15%), CVD (n=11, 21%) or Diabetes (n=33, 62%). A significant (P< .01) summary effect was found for disease knowledge (SES=1.27 [n=23, 95%CI=1.05-1.49]), attitude (SES=1.17 [n=20, 95%CI=0.88-1.47]), and behaviour (SES=1.20 [n=31, 95%CI=0.94-1.46]). These results support the conclusion that there is compelling evidence, in particular, for patients with Diabetes, that health-literacy interventions are effective in promoting disease knowledge, attitude and behaviour across four chronic conditions that drive the burden of NCDs.

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

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.

How to tackle health literacy problems in chronic kidney disease patients? A systematic review to identify promising intervention targets and strategies.

BackgroundLimited health literacy (LHL) is associated with multiple adverse health outcomes in chronic kidney disease (CKD). Interventions are needed to improve this situation, but evidence on intervention targets and strategies is lacking. This systematic review aims to identify potential targets and strategies by summarizing the evidence on: (i) patient- and system-level factors potentially mediating the relation between LHL and health outcomes; and (ii) the effectiveness of health literacy interventions customized to CKD patients. MethodsWe performed a systematic review of peer-reviewed research articles in Medline, Embase and Web of Science, 2009–19. We assessed the quality of the studies and conducted a best-evidence synthesis.ResultsWe identified 860 publications and included 48 studies. Most studies were of low quality (n = 26) and focused on dialysis and transplantation (n = 38). We found strong evidence for an association of LHL with smoking and having a suboptimal transplantation process. Evidence was weak for associations between LHL and a variety of factors related to self-care management (n = 25), utilization of care (n = 23), patient–provider interaction (n = 8) and social context (n = 5). Six interventions were aimed at improving knowledge, decision-making and health behaviours, but evidence for their effectiveness was weak.ConclusionsStudy heterogeneity, low quality and focus on kidney failure largely impede the identification of intervention targets and strategies for LHL. More and higher quality studies in earlier CKD stages are needed to unravel how LHL leads to worse health outcomes, and to identify targets and strategies to prevent disease deterioration. Healthcare organizations need to develop and evaluate efforts to support LHL patients.

Effect of health literacy interventions on pregnancy outcomes: A systematic review

BackgroundLow health literacy has been associated with worse health outcomes, but little is known about the effectiveness of health literacy interventions developed for pregnant women. AimTo assess the effectiveness of health literacy interventions on pregnancy outcomes through a systematic review of randomised controlled trials. MethodsRandomised controlled trials that assessed health literacy interventions designed to improve pregnancy outcomes were included. The study protocol was registered with PROSPERO (CRD42018094958). FindingsOf the 1512 records initially identified, 13 studies were included. Three reported on decision-aid interventions, six on face-to-face interventions and four on written interventions (including computer-based interventions or information leaflets). The primary outcomes of interest for this systematic review were knowledge (10/13 studies) and health literacy (2/13 studies) with one study not reporting either primary outcome. A significant improvement in knowledge was found across the 10 studies, however the two studies which measured health literacy only assessed health literacy at a single time-point. Secondary outcomes including health behaviours, fetal outcomes and health-service utilisation were reported in 11 studies, with inconsistent results. DiscussionFew health literacy interventions have been developed specifically for pregnant women. Although health literacy interventions have the potential to improve knowledge and pregnancy outcomes, current evidence is limited by inconsistent outcomes and measurement, and limited use of health literacy theory to inform intervention design and content. Few studies directly measured health literacy. ConclusionMore research is needed to properly assess the effect of health literacy interventions on pregnancy outcomes. This research should include consideration of health literacy theory in the development of the interventions.

Evidence on the effectiveness of health literacy interventions in the EU: a systematic review

BackgroundIn the last decade, the attention for health literacy has increased in the European Union. This is due to three main reasons. First, reviews have shown that inadequate health literacy is associated with worse health outcomes, higher health care use and expenditure. Second, in all European countries the population is aging and the number of chronically ill people is rising. Improving health literacy in this group can offer greater opportunities to take an active part in society, be independent and improve quality of life. Third, since most research on health literacy has been conducted outside Europe and relatively little is known about the development of health literacy interventions and its effects on outcome measures in European countries. The aim of this systematic review was to assess the evidence on the effectiveness of health literacy interventions in the European Union published between 1995 and 2018.MethodsSearches have been performed in Medline, PubMed, EMBASE, CINAHL, Cochrane library, PsychINFO, ERIC, Web of Science and SCOPUS for publications on health literacy intervention studies in European Union countries. Studies were included if the research was conducted in one or more Member States of the European Union, the publication described an intervention study, the intervention was aimed at health literacy, the publication described an outcome measure related to health literacy and the publication was written in English, French or German.ResultsA total of 23 studies were included. Three types of interventions were identified; aimed at improving health literacy, tailored to different health literacy levels and aimed at improving health outcomes in general that differentiated in effects for people with different health literacy levels. Most interventions identified in the review focus on the functional level of health literacy or numeracy. The strength of evidence from the European health literacy intervention studies was low and there was a huge heterogeneity in study design, measurement tools and outcomes measured.ConclusionsPromising interventions were tailored to the needs of patients, addressing functional, interactive and critical skills and use not difficult animated spoken text. Future research should focus on the development and assessment of such interventions and use stronger designs.

The effectiveness of health literacy interventions on health-related outcomes among socioeconomically disadvantaged adults living in the community: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE The overall objective of this systematic review is to identify and synthesize the best available evidence on the effectiveness of health literacy interventions in socioeconomically disadvantaged people living in the community to improve health-related outcomes. More specifically, the objectives of this systematic review are to identify and synthesize evidence on the effectiveness of single or complex health literacy interventions in enabling socioeconomically disadvantaged people living in the community to access, understand, appraise and apply health information. INCLUSION CRITERIA Types of participants This review will consider studies that include adults aged 18 years or over, male and female, of any ethnicity and cultural group, and who are socially or socioeconomically disadvantaged in the community. PROGRESS factors, including Place of residence, Race/ethnicity - culture - language, Occupation, Gender, Religion, Education, Socio economic status, Social capital or age, will serve to identify “disadvantaged” people and social groups. These are “socially stratifying factors that drive variations in health outcomes” and contribute to disparities in health. For example, people living in rural areas, from a minority group, with low education or low income, are considered as disadvantaged and are at risk of health disparities. In this review, studies considering any or several of these factors will be considered for inclusion. In this review, studies conducted in any community setting will be considered, such as community centers, community preventive services, community-based health promotion settings, community healthcare facilities, primary healthcare centers, homes or worksite settings. Exclusion criteria: studies involving children aged under 18 years TRUNCATED AT 250 WORDS

The effectiveness of health literacy interventions on the informed consent process of health care users: a systematic review protocol.

REVIEW QUESTION / OBJECTIVE The aim of this systematic review is to establish the best available evidence of the effectiveness of health literacy interventions on the informed consent process for health care users. The specific review question is: What is the effectiveness of health literacy interventions on health care users' informed consent to health procedures processes? INCLUSION CRITERIA Types of participants This review will consider all studies that include adults (18 years or over) receiving care or adults who are proxies of incompetent health care users or of children (parents or guardians) who have been actively involved in an informed consent process regarding health care procedures. Participants may be healthy or may have any kind of physical disability, be recruited in any type of health care environment, including acute (hospital), primary care, psychiatric and aged care, in any health specialty, including medicine, dentistry and pharmacy. Studies whose participants have cognitive impairment will be excluded. Studies on informed consent processes for research participants will be also excluded. Types of intervention(s) The interventions, methods, and strategies will be included if: - they aim to improve the informed consent process related to health issues among health care users or their proxies, - they are designed taking into consideration health literacy as a main concept, and - the intervention is provided by any health care provider. Such interventions my focus on either the material provided (e.g. readability, processability), or the supportive procedure of informed consent (e.g. video) in order to decrease the health literacy TRUNCATED AT 250 WORDS

What health literacy interventions are effective in the primary healthcare settings in weight loss management—A systematic review

To assess the effectiveness of health literacy interventions in achieving weight loss in adults with overweight or obesity. Studies were obtained from searches of 17 electronic bibliographic databases, hand searching, relevant websites, and personal communication. Intervention studies using experimental or quasi-experimental methods conducted in primary healthcare (PHC) or by a PHC professional outside the PHC setting with a minimum 6 months followup, published in the English language between 1989 and June 2013 in one of the OECD member countries. Studies where patients had any chronic disease were excluded. Three authors extracted data and one independently assessed trial quality. Nineteen studies were included with 3747 participants (71% females). Of these, 15 were patient-focussed, one provider-focussed and three studies addressed both. Three studies included elements of functional, 15 of interactive and one of critical health literacy. All targeted lifestyle (diet and physical activity). Fourteen studies were randomised trials with nine showing significant between-group weight loss differences over a period of 6—12 month follow up. All five nonrandomised trials showed significant weight losses over a period of 6—18 month follow up. Five studies included patients from a disadvantaged background. Participants in 11 studies were at a high risk of developing diabetes. Duration of studies was 9 months (8). The intervention was delivered individually (4), group sessions (9), mixed group and individual (3), internet only (1), mixed telephone and internet (1), and mixed telephone and individual (1). The intervention was delivered by diabetes educators, dieticians, health promotion and internet counsellors, lay leaders, medical practitioners, nurses, physiotherapists, physical activity specialists, psychologists, traditional wellness coordinators, and the Internet. The results of this review show the effectiveness of a variety of health literacy-focussed lifestyle modification programs, incorporating physical activity and dietary changes, in achieving weight loss.

Nutrition and Health Literacy: A Systematic Review to Inform Nutrition Research and Practice

Health literacy is defined as the degree to which individuals obtain, process, and understand basic health information and services to make informed health decisions. Health literacy is a stronger predictor of health than age, income, employment, education, and race. Although the field has grown during the past decade, most health literacy research does not explicitly focus on food or nutrition, and dietetics practitioners often remain unaware of patients' health literacy level. The purpose of this systematic review was to summarize the literature on nutrition and health literacy to enhance dietetics practitioners' awareness of the importance of health literacy in practice and research. Of the 33 studies reviewed, four focused on measurement development, 16 on readability assessments, and 13 on individual literacy skills assessments. Collective evaluation revealed four noteworthy gaps, including the need to use more comprehensive assessment approaches that move beyond readability and numeracy to address the full spectrum of health literacy factors; the need to apply more robust experimental studies to examine the effectiveness of health literacy interventions among individuals, communities, health care providers, and health care systems; the need to explore the moderating and mediating roles of an individual's health literacy status on nutrition outcomes; and the need to examine long-term effects of health literacy interventions on nutrition outcomes. This article defines health literacy gaps and opportunities in nutrition research and practice, and calls for continued action to elevate the role of dietetics practitioners in addressing health literacy.