Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review

Walters, Ronie; Leslie, Stephen J; Polson, Rob; Cusack, Tara; Gorely, Trish

doi:10.1186/s12889-020-08991-0

Cited by 144 publications

(142 citation statements)

References 68 publications

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“…Although evidence for the benefit of health literacy interventions in cardiac rehabilitation is limited, a recent systematic review [ 47 ] found two successful interventions with cardiac patients, and additionally that in seven out of eight studies (any population) health literacy interventions had a positive effect on health behaviours. However, it is worth considering that many health literacy interventions still focus on functional health literacy and making information easier to understand.…”

Section: Discussionmentioning

confidence: 99%

Health Literacy for Cardiac Rehabilitation: An Examination of Associated Illness Perceptions, Self-Efficacy, Motivation and Physical Activity

Walters

Leslie

Sixsmith

et al. 2020

IJERPH

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Following a diagnosis of cardiovascular disease there is a need for patients to self-manage. Health literacy has been shown to be lower in patients with cardiovascular disease, yet research into health literacy in this population is limited. This study used the Health Literacy Questionnaire (HLQ) to examine the health literacy and associated health, health behaviours and psychological profiles of cardiac rehabilitation patients from a remote and rural regional programme in the Scottish Highlands. Consecutive patients referred to the service in a calendar year were sent a cross-sectional questionnaire by post. Hierarchical cluster analysis grouped respondents based on their health literacy profile, and nonparametric methods were used to analyse differences between clusters on the other measures. A total of 282 participants responded (45.7%). Respondents were older (median: 71 years) and more likely to be from more affluent areas. Five health literacy clusters emerged with different profiles of health, physical activity, self-efficacy, motivation and illness perceptions. There was no difference in relation to cardiac rehabilitation attendance by health literacy cluster, but those with lower health literacy were less likely to be aware of the referral. Patterns of health literacy are associated with health, health behaviours and some psychological constructs. Knowledge of distinct cluster characteristics may help services better target interventions.

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Section: Discussionmentioning

confidence: 99%

Health Literacy for Cardiac Rehabilitation: An Examination of Associated Illness Perceptions, Self-Efficacy, Motivation and Physical Activity

Walters

Leslie

Sixsmith

et al. 2020

IJERPH

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“…There is promising evidence showing the effectiveness of health literacy interventions on health outcomes at the individual and community level [ 20 , 48 , 49 , 50 ]. However, there remain substantial gaps.…”

Section: What Is Known Already?mentioning

confidence: 99%

“…This is the same case in the field of health literacy [ 93 , 94 ]. While the importance of health literacy is increasingly recognized in national and global health initiatives [ 23 , 62 , 95 ], there is still a long way to go when applying health literacy into current practice [ 50 , 96 ]. The evidence synthesis shows that, of the 46 existing and developing health literacy policies in European regions, the main barriers influencing the successful implementation of health literacy policy include cultural barriers, budget restrictions, and the difficulty obtaining high-quality evidence.…”

Section: What Evidence Is Needed?mentioning

confidence: 99%

Moving Health Literacy Research and Practice towards a Vision of Equity, Precision and Transparency

Guo

Okan

2020

IJERPH

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Over the past two decades, health literacy research has gained increasing attention in global health initiatives to reduce health disparities. While it is well-documented that health literacy is associated with health outcomes, most findings are generated from cross-sectional data. Along with the increasing importance of health literacy in policy, there is a lack of specificity and transparency about how to improve health literacy in practice. In this study, we are calling for a shift of current research paradigms from judging health literacy levels towards observing how health literacy skills are developed over the life course and practised in the real world. This includes using a life-course approach, integrating the rationale of precision public health, applying open science practice, and promoting actionable knowledge translation strategies. We show how a greater appreciation for these paradigms promises to advance health literacy research and practice towards an equitable, precise, transparent, and actionable vision.

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“…Like literacy in general, HL is thought to be a learned skill [ 6 ], and it is positively associated with level of education in many studies [ 5 ]. A systematic review aimed at establishing the efficacy of interventions to improve health literacy and health behavior, concluded that HL interventions hold potential to combat health inequalities [ 2 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Is health literacy of family carers associated with carer burden, quality of life, and time spent on informal care for older persons living with dementia?

2020

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Introduction Family carers are cornerstones in the care of older people living with dementia. Family carers report extensive carer burden, reduced health-related quality of life (HRQoL), and extensive time spent on informal care (Time). Health literacy (HL) is a concept associated with people’s ability to access health services, and navigate the healthcare system. This study’s aim was to investigate HL among family carers, and investigate the associations between HL and carer burden, HRQoL, and Time spent on informal care. Method We designed a self-administered survey comprising validated instruments, including the Health Literacy Scale (HLS-N-Q12) to measure HL, Relative Stress Scale (RSS) to measure carer burden, the EQ-5D-5L instrument to measure HRQoL, and some modified questions from the Resource Utilization in Dementia (RUD) questionnaire to measure time spent on informal care (Time). Descriptive analysis in addition to bivariate and multiple linear regressions were undertaken. In multiple linear regression analysis, we used HL as the independent variable to predict the outcomes (carer burden, HRQoL, Time). Analyses were adjusted for the effects of explanatory independent variables: age, gender, education levels, urban residency, having worked as health personnel, caring for someone with severe/mild dementia, and being born abroad. Findings In a non-probability sample of 188 family carers from across Norway, most of them female and over the age of 60, we found high levels of HL. In the bivariate analysis, carer burden and HRQoL (EQvalue) showed significant associations with HL. In the multiple regression analyses, HL was statistically significantly associated with carer burden (B = -0.18 CI:-0.33,-0.02 p = 0.02), HRQoL (EQvalue: B = 0.003 with 95% CI: 0.001, 0.006 p = 0.04), and Time (B = -0.03 with 95% CI: -0.06, 0.000, p = 0.046), after adjusting for the effect of independent variables. Conclusion This is one of the first studies to investigate the associations between HL and different outcomes for family carers of older people living with dementia. Additional research into the associations identified here is needed to further develop our understanding of how to support family carers in their roles. Targeted support that increases family carers’ HL may have potential to enhance their ability to provide sustainable care over time.

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Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review

Cited by 144 publications

References 68 publications

Health Literacy for Cardiac Rehabilitation: An Examination of Associated Illness Perceptions, Self-Efficacy, Motivation and Physical Activity

Health Literacy for Cardiac Rehabilitation: An Examination of Associated Illness Perceptions, Self-Efficacy, Motivation and Physical Activity

Moving Health Literacy Research and Practice towards a Vision of Equity, Precision and Transparency

Is health literacy of family carers associated with carer burden, quality of life, and time spent on informal care for older persons living with dementia?

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