A Review and Report of Community-based Health Literacy Interventions

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Baur, C., Martinez, L. M., Tchangalova, N. & Rubin, D. (2017). A review and report of community-based health literacy interventions. Presentation and paper at Roundtable on Health Literacy, The National Academies of Sciences, Engineering, and Medicine, Washington, D.C. Available at http://www.nationalacademies.org/hmd/Activities/PublicHealth/HealthLiteracy/2017-JUL-19.aspx


BACKGROUND: A scoping literature review was conducted to identify and describe the state-of the-art of community-based health literacy interventions. “Health literacy” and “community” were the core concepts used to identify relevant interventions for review and analysis. “Health literacy,” “community” and “community-based” are terms with a range of meanings, and the review aimed to find and report those interventions that intentionally brought together groups of people to participate in an intervention that addressed health literacy issues or tried to change health literacy skills, behaviors, status, or other outcomes as defined by researchers.

METHODS: Literature searching was conducted using PubMed, selected EBSCO and Proquest databases, as well as Web of Science for relevant studies. Grey literature was searched on web sites to identify eligible community-based programs. Search results were limited to English publications from June 2010 to 2017, however no limit was applied to geographical location, participants, health topic, or intervention type. Two authors screened titles and abstracts and identified 170 references suitable for full-text analysis. Papers were reviewed using a standard template with descriptive categories about the intervention; and criteria from the CDC “Best Practices” for evidence-based practices and Guide to Community Preventive Services study designs.

RESULTS: Of the 2,402 papers located with the search strategy, 74 papers met the inclusion criteria. Of the included papers, 55 reported that intervention communities were selected because of health literacy concerns; 63 reported that health literacy principles or techniques were used for content or program development; 54 used health literacy measures; and 53 included health literacy outcome information. Only two papers reported large magnitude effects.

CONCLUSIONS: A wide range of community-based health literacy interventions provide qualitative and quantitative evidence of positive outcomes; knowledge change was the most common outcome. Interventions can be strengthened in a number of ways to continue to build the body of knowledge about when and how to best address health literacy in community interventions.