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Systematic Review
The objectives of this review were: i) to identify and synthesize the best available evidence on the effectiveness on health-related outcomes of health literacy interventions for enabling socioeconomically disadvantaged people living in the community to access, understand, appraise and apply health information; and ii) to identify components of health literacy interventions associated with improved health-related outcomes.
Only one study in this review met the inclusion criteria of this evidence map (Stockwell et al. 2014):
'This RCT included 1153 low-income women initiating prenatal care, 576 of whom participated in the experimental group (EG) and 577 in the control group (CG). Participants in the EG received health information and health education about influenza during pregnancy through five weekly text messages. The text messages covered various topics such as risk of influenza for the pregnant woman and fetus, vaccine safety and vaccine recommendations. Participants in the CG received usual care. At four months follow-up, there was a higher rate of vaccination in the EG than in the CG (P = 0.048).'
In regards to the findings from the wider review, the authors state:
Twenty-one studies were included in the review. Three studies addressed the health literacy competency of understanding health information, and 18 addressed the competency of applying health information. Thirteen studies were found as effective based on a variety of health-related outcomes (mainly clinical outcomes), preventive health practices and behaviors, and health-promoting behaviors. Results enabled identification of some effective intervention operational components, including cultural appropriateness, tailoring, skills building, goal setting and active discussions. Multi-faceted interventions, combining both an information transfer medium and contact with an interventionist, appear to be more effective than single modality interventions. The use of an appropriate theoretical foundation is also an important factor for successful interventions.
The authors state:
"To improve health-related outcomes among socioeconomically disadvantaged people, health literacy interventions are more likely to be successful if they are theory-based, are multi-faceted and use person-centered operational components such as cultural appropriateness, tailoring, skills building, goal setting and active discussions."