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. 2024 Feb 19:12:1332720.
doi: 10.3389/fpubh.2024.1332720. eCollection 2024.

Interventions to promote health literacy among working-age populations experiencing socioeconomic disadvantage: systematic review

Himal Singh  1 , Florence Samkange-Zeeb  2 , Jonathan Kolschen  1 , Ruben Herrmann  1 , Wiebke Hübner  2 , Núria Pedrós Barnils  1 , Tilman Brand  2 , Hajo Zeeb  2   3 , Benjamin Schüz  1   3
Affiliations

Interventions to promote health literacy among working-age populations experiencing socioeconomic disadvantage: systematic review

Himal Singh et al. Front Public Health. .

Abstract

Background: Experiencing financial insecurity and being underserved is often associated with low health literacy, i.e., the ability to identify, obtain, interpret and act upon health information, which may result in poor health outcomes. Little is known about effective interventions for promoting health literacy among underserved populations. The objective of this systematic review is to summarize the literature on such interventions and identify characteristics that differentiate more effective interventions.

Methods: Following PRISMA guidelines we searched the databases SCOPUS, Pubmed, Web of Science core collection and CINAHL. We included primary studies with a quantitative study design and control groups testing interventions to increase health literacy or health knowledge in underserved populations between 18 and 65 years. Where possible, we converted effect sizes into Cohen's d and compared mean differences of intervention and control groups. Albatross plots were created to summarize the results according to different health literacy and health knowledge outcomes.

Results: We screened 3,696 titles and abstracts and 206 full texts. In total, 86 articles were analyzed, of which 55 were summarized in seven albatross plots. The majority of the studies (n = 55) were conducted in the United States and had a randomized controlled study design (n = 44). More effective intervention approaches assessed needs of participants through focus group discussions prior to conducting the intervention, used bilingual educational materials, and included professionals fluent in the first languages of the study population as intervention deliverers. Additionally, the use of educational materials in video and text form, fotonovelas and interactive group education sessions with role playing exercises were observed to be effective.

Discussion: Although the outcomes addressed in the included studies were heterogeneous, effective intervention approaches were often culturally sensitive and developed tailored educational materials. Interventions aiming to promote health literacy in underserved populations should hence consider applying similar approaches.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323801, PROSPERO registration ID: CRD42022323801.

Keywords: albatross plots; face-to-face; health literacy; intervention strategies; multilingual education; socioeconomically disadvantaged; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart of the search process.
Figure 2
Figure 2
Albatross plot—functional health literacy.
Figure 3
Figure 3
Albatross plot—mental health literacy.
Figure 4
Figure 4
Albatross plot—cancer screening knowledge.
Figure 5
Figure 5
Albatross plot – Child feeding knowledge.
Figure 6
Figure 6
Albatross plot—diabetes knowledge.
Figure 7
Figure 7
Albatross plot—food knowledge.
Figure 8
Figure 8
Albatross plot—HIV knowledge.
Figure 9
Figure 9
Risk of bias analysis.
See this image and copyright information in PMC

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