Can community-based peer support promote health literacy and reduce inequalities? A realist review – 2015 [UK]
Community-based peer support (CBPS) has been proposed as a potentially promising approach to improve health literacy and reduce health inequalities. Peer support, however, is described as a public health intervention in search of a theory, and as yet there are no systematic reviews exploring why or how peer support works to improve health literacy. This review (191 pages), by Harris et al (2015) for the National Institute for Health Research, is a participatory realist synthesis and is aimed at developing a better understanding of the potential for CBPS to promote better health literacy and reduce health inequalities. Studies written in English describing CBPS research/evaluation, and related papers describing theory, were included. The researchers concluded that peer-support programmes have the potential to improve health literacy and reduce health inequalities but potential is dependent upon the surrounding equity context. More explicit empirical research is needed, which establishes clearer links between peer-supported health literacy and health inequalities.
eHealth literacy interventions for older adults: A systematic review of the literature – 2014 [US]
This paper, by Watkins and Zie (2014), reports findings from a systematic review of 23 articles on health literacy interventions and eHealth literacy interventions for older adults drawn from 28 relevant databases in nine fields. The eHealth literacy interventions in the sampled articles used eHealth literacy as an outcome of interest, applied learning theories, and occurred in informal learning settings such as senior centers and public libraries. In contrast, health literacy interventions (that involved ICTs as a key aspect of their interventions) often targeted specific health outcomes, applied health behavior theories, and occurred in both informal learning and clinical settings. These results indicate a significant gap in the literature on eHealth literacy interventions that use health outcomes for outcome measures. Additionally, most of the studies used no theoretical framework, and only seven studies were RCTs. These results highlight a great need to develop and assess theory-based interventions applying high-quality research design.
Health literacy measurement: An inventory and descriptive summary of 51 instruments – 2014 [US]
This article, by Haun et al (2014), aimed to provide a descriptive review of the psychometric properties and conceptual dimensions of published health literacy measurement tools. A review of medical articles and grey literature, and an environmental scan was conducted to identify health literacy measurement tools. For each tool, the researchers evaluated the conceptual dimensions assessed, test parameters, and psychometric properties. Of the 51 tools identified, 26 measured general health literacy, and 15 were disease or content specific, and 10 aimed at specific populations. The researchers found that the validation procedures for most of the tools are limited by inadequate power to ensure reliability across subgroups; represent a narrow set of conceptual dimensions with limited modes of administration; and most tools lack information on key psychometric properties. The researchers concluded that most tools were unsuitable for accurately determining patient health literacy skills and that significant work is needed to establish important aspects of the construct, convergent, and predictive validity for many tools. As researchers develop new measures, inclusion of a full range of conceptual dimensions of health literacy, more representative sampling for testing, and additional modes of administration will allow a more refined and flexible approach to research in this field.
Numeracy Skill And The Communication, Comprehension, and Use Of Risk-Benefit Information – 2007 [US]
Numeracy skills are an important aspect of health literacy. In this paper Peters et al (2007) review the literature on numeracy as a concept, examine why numeracy skills are important to health care decision-making, what the best practices are for the presentation of numeric health information and what strategies can be used to help less numerate people act more effectively and take charge of their health.
Do rehabilitation professionals need to consider their clients’ health literary for effective practice? [Can]
Rehabilitation professionals are often uniformed about and neglect health literacy in their interventions. Levasseur and Carrier (2010) reviewed the scientific and grey literature on health, rehabilitation and health promotion with the objective of determining the importance of integrating health literacy into rehabilitation practice. The authors found that all papers addressing both health literacy and rehabilitation specifically mentioned that rehabilitation professionals need to consider their clients’ health literacy. The effectiveness of rehabilitation interventions and clients’ long-term health might depend on various factors, including health literacy. Levasseur and Carrier (2010) recommend that rehabilitation professionals be aware of the importance of health literacy and intervene to improve it. The challenge is now to better understand how health literacy influences the effectiveness of rehabilitation and health outcomes.
Integrating health literacy into occupational therapy: findings from a scoping review [Can]
This paper by, Levasseur and Carrier (2012), aimed to report ways of integrating health literacy into occupational therapy practice. A scoping study of the scientific and grey literature on health, occupational therapy and health promotion was done from 1980 to May 2010. Five databases were searched and data were extracted from 44 documents. The authors found that the literature on health literacy needs enhancing in both quantity and quality. Six ways of integrating health literacy into occupational therapy practice were identified. Occupational therapists should 1) be informed about and recognize health literacy, 2) standardize their practice, 3) make information accessible, 4) interact optimally with clients, 5) intervene, and 6) collaborate to increase health literacy. Since health literacy can directly impact intervention efficacy, Levasseur and Carrier (2012), recommend that further studies need to be done on how to integrate health literacy into occupational therapy practice.
A Systematic Review of Asthma and Health Literacy: A Cultural-Ethnic Perspective in Canada
In order to find links between asthma and health literacy in a cultural/ethnicity perspective, Poureslami et al (2007) performed a systematic review of all publications on the topic of asthma, health, and literacy among cultural groups from 1980 to 2006 using the Internet and journals. They conclude that there is an urgent need to better define the impact of cultural and ethnic issues in the management of asthma in Canada. Appropriately designed studies should better define the barriers in the optimal delivery of asthma care influenced by these parameters.
Health Literacy and ophthalmic patient education
In this article by Muir and Lee (2010), the authors review the readability of currently available ophthalmic educational materials, with particular attention to the health literacy status of the patient population for which the materials are intended.
Health in the ‘hidden population’ of people with low literacy. A systematic review of the literature
This article by Easton et al (2010) reviewed published research to investigate relationships between low functional or health literacy and health in working age adults who can converse in the dominant language but have difficulty with written language. They found that there is evidence in the literature that low functional or health literacy is associated with poor health in the 'hidden population' of adults whose literacy difficulties may not be evident to health care providers.
Understanding the Internal and External Validity of Health Literacy Interventions: A Systematic Literature Review Using the RE-AIM Framework
In this study by Allen et al (2011) the authors conducted a systematic literature review, using the RE-AIM framework, with the goal of determining what information is available to inform research to practice translation of health promotion interventions developed to address health literacy. They suggest that the current research on health promotion for participants with low health literacy provides insufficient information to conclude whether interventions for health literacy can attract the target population, achieve an effect that is sustainable, or be generalized outside of clinical settings.