"A bit of everything": Health literacy interventions in chronic conditions - a systematic review

Marie H Larsen; Anne Marit Mengshoel; Marit H Andersen; Christine R Borge; Birgitte Ahlsen; Kari Gire Dahl; Hedda Eik; Heidi Holmen; Anners Lerdal; Kari L Mariussen; Lisbeth Thoresen; Merete K Tschamper; Kristin H Urstad; Tone K Vidnes; Astrid K Wahl

doi:10.1016/j.pec.2022.05.008

"A bit of everything": Health literacy interventions in chronic conditions - a systematic review

Patient Educ Couns. 2022 Oct;105(10):2999-3016. doi: 10.1016/j.pec.2022.05.008. Epub 2022 May 23.

Authors

Affiliations

¹ Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Lovisenberg Diaconal University College, Oslo, Norway. Electronic address: m.h.larsen@medisin.uio.no.
² Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway. Electronic address: a.m.mengshoel@medisin.uio.no.
³ Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: m.h.andersen@medisin.uio.no.
⁴ Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Lovisenberg Diaconal Hospital AS, Oslo, Norway. Electronic address: c.r.borge@medisin.uio.no.
⁵ Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway. Electronic address: birgitte.ahlsen@oslomet.no.
⁶ Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: dahkar@ous-hf.no.
⁷ Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway. Electronic address: hedda.eik@medisin.uio.no.
⁸ Faculty of Health Sciences, Department of Nursing and Health Promotion - Oslo Metropolitan University, Norway. Electronic address: Heidi.holmen@oslomet.no.
⁹ Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Lovisenberg Diaconal Hospital AS, Oslo, Norway. Electronic address: anners.lerdal@medisin.uio.no.
¹⁰ Lovisenberg Diaconal University College, Oslo, Norway. Electronic address: Kari.L.Mariussen@ldh.no.
¹¹ Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway. Electronic address: lisbeth.thoresen@medisin.uio.no.
¹² Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; National Centre for Epilepsy, Devision of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: m.k.tschamper@medisin.uio.no.
¹³ Faculty of Health Sciences, University of Stavanger, Stavanger, Norway. Electronic address: kristin.h.urstad@uis.no.
¹⁴ Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: tvidnes@ous-hf.no.
¹⁵ Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences-University of Oslo, Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: a.k.wahl@medisin.uio.no.

PMID: 35641366
DOI: 10.1016/j.pec.2022.05.008

Abstract

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 heterogeneity of theoretical underpinnings, modes, measures and content. We identified 23 HL measures, mostly assessing 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.

Keywords: Chronic diseases; Health literacy; Interventions; Systematic review.

Publication types

Review
Systematic Review

MeSH terms

Chronic Disease
Health Literacy* / methods
Humans