Improving health literacy in community populations: a review of progress

Abstract

Governments around the world have adopted national policies and programs to improve health literacy. This paper examines progress in the development of evidence to support these policies from interventions to improve health literacy among community populations. Our review found only a limited number of studies (n=7) that met the criteria for inclusion, with many more influenced by the concept of health literacy but not using it in the design and evaluation. Those included were diverse in setting, population and intended outcomes. All included educational strategies to develop functional health literacy, and a majority designed to improve interactive or critical health literacy skills. Several papers were excluded because they described a protocol for an intervention, but not results, indicating that our review may be early in a cycle of activity in community intervention research. The review methodology may not have captured all relevant studies, but it provides a clear message that the academic interest and attractive rhetoric surrounding health literacy needs to be tested more systematically through intervention experimentation in a wide range of populations using valid and reliable measurement tools. The distinctive influence of the concept of health literacy on the purpose and methodologies of health education and communication is not reflected in many reported interventions at present. Evidence to support the implementation of national policies and programs, and the intervention tools required by community practitioners are not emerging as quickly as needed. This should be addressed as a matter of priority by research funding agencies.

Improving health literacy in a Japanese community population—A pilot study to develop an educational programme

“…Few interventional studies have attempted to improve higher level health literacy (i.e. interactive and critical health literacy) . The findings of our qualitative analysis suggest that participants obtained basic knowledge and skills concerning health‐care systems, interpersonal and communication skills, and the seeking of information, which were precisely the learning points that this programme was designed to offer.…”

“…Health literacy can be improved by providing information, effective communication and a structured education . With growing evidence of the relationship between inadequate health literacy and poor health outcomes, interventional research has been conducted with the aim of resolving problems related to inadequate health literacy.…”

“…These studies have provided evidence that individuals with lower health literacy can be identified and supported to develop a better understanding of and skills to improve health behaviours and outcomes. On the other hand, fewer interventions have been conducted in community settings, and less emphasis has been placed on improving higher level interactive and critical health literacy vs functional health literacy …”

Social & psychological factors associated with oral analgesic use in knee osteoarthritis management

“…Quality of social relationships, psychological/personality dispositions, and other psychosocial risk factors may all be targeted 24,25 . Health literacy can be improved through provision of information, effective communication, and structured education 26 . The primary objective of this study was to determine which potentially modifiable social and psychological health factors are associated with use of various oral analgesic treatments in a sample of patients with chronic knee pain due to OA.…”

Sickle cell carriers' unmet information needs: Beyond knowing trait status

“…For example, it was apparent that when information on the genetic risk for SCD was received, carriers did not accurately understand these risks. Therefore, implementing strategies such as the “teach‐back” method may be helpful to confirm that this information has been accurately received (Nutbeam et al, ; Porter et al, ). This method is shown to be effective in genetic education (Porter et al, ; Tluczek et al, ).…”