"A bit of everything": Health literacy interventions in chronic conditions- a systematic review
Larsen, Marie Hamilton; Mengshoel, Anne Marit; Andersen, Marit Helen; Borge, Christine Råheim; Ahlsen, Birgitte; Dahl, Kari Gire; Eik, Hedda; Holmen, Heidi; Lerdal, Anners; Mariussen, Kari; Thoresen, Lisbeth; Tschamper, Merete Kristin; Urstad, Kristin Hjorthaug; Vidnes, Tone Karine; Wahl, Astrid Klopstad
Peer reviewed, Journal article
Published version
Date
2022Metadata
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Original version
10.1016/j.pec.2022.05.008Abstract
Objective:
To systematically evaluate health literacy (HL) interventions in chronic conditions by exploring
theoretical perspectives, intervention content and effectiveness.
Method:
We searched MEDLINE, Cochrane, CINAHL, EMBASE, ERIC, Web of Science and PsycINFO. Standardised
systematic review methods were used, and sequences informing our research question were extracted and
analysed. The study includes a descriptive summary of the included papers.
Results: We included 39 unique interventions, with diabetes and heart disease as the most targeted chronic
conditions. Fifty-four percent of papers included a definition of HL, but the studies showed significant hetero-geneity of theoretical underpinnings, modes, measures and content. We identified 23 HL measures, mostlyassessing functional HL. The HL interventions were often more complex than the measures indicated. A significant change in HL was found in 28 studies. Study quality was generally poor.
Conclusions:
Interventions optimizing HL appear important to improve health outcomes in chronic conditions. To
ensure cumulative knowledge development of this field we need theory-based interventions, consistency in
methods and more tailored and comprehensive measures to capture the interventions’ complexity.
Practice implications: A more valid understanding of HL interventions and measurements is needed to reach an agreed understanding of their components and intentions.