The Resource Health literacy interventions and outcomes : an updated systematic review, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI International-University of North Carolina Evidence-based Practice Center ; investigators, Nancy D. Berkman ... [et al.], (electronic resource)

Health literacy interventions and outcomes : an updated systematic review, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI International-University of North Carolina Evidence-based Practice Center ; investigators, Nancy D. Berkman ... [et al.], (electronic resource)

Label
Health literacy interventions and outcomes : an updated systematic review
Title
Health literacy interventions and outcomes
Title remainder
an updated systematic review
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI International-University of North Carolina Evidence-based Practice Center ; investigators, Nancy D. Berkman ... [et al.]
Contributor
Subject
Genre
Language
  • eng
  • eng
Summary
OBJECTIVES: To update a 2004 systematic review of health care service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy. Disparities in health outcomes and effectiveness of interventions among different sociodemographic groups were also examined. DATA SOURCES: We searched MEDLINE,(r) the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, PsychINFO, and the Educational Resources Information Center. For health literacy, we searched using a variety of terms, limited to English and studies published from 2003 to May 25, 2010. For numeracy, we searched from 1966 to May 25, 2010. REVIEW METHODS: We used standard Evidence-based Practice Center methods of dual review of abstracts, full-text articles, abstractions, quality ratings, and strength of evidence grading. We resolved disagreements by consensus. We evaluated whether newer literature was available for answering key questions, so we broadened our definition of health literacy to include numeracy and oral (spoken) health literacy. We excluded intervention studies that did not measure health literacy directly and updated our approach to evaluate individual study risk of bias and to grade strength of evidence. RESULTS: We included good- and fair-quality studies: 81 studies addressing health outcomes (reported in 95 articles including 86 measuring health literacy and 16 measuring numeracy, of which 7 measure both) and 42 studies (reported in 45 articles) addressing interventions. Differences in health literacy level were consistently associated with increased hospitalizations, greater emergency care use, lower use of mammography, lower receipt of influenza vaccine, poorer ability to demonstrate taking medications appropriately, poorer ability to interpret labels and health messages, and, among seniors, poorer overall health status and higher mortality. Health literacy level potentially mediates disparities between blacks and whites. The strength of evidence of numeracy studies was insufficient to low, limiting conclusions about the influence of numeracy on health care service use or health outcomes. Two studies suggested numeracy may mediate the effect of disparities on health outcomes. We found no evidence concerning oral health literacy and outcomes. Among intervention studies (27 randomized controlled trials [RCTs], 2 cluster RCTs, and 13 quasi-experimental designs), the strength of evidence for specific design features was low or insufficient. However, several specific features seemed to improve comprehension in one or a few studies. The strength of evidence was moderate for the effect of mixed interventions on health care service use; the effect of intensive self-management inventions on behavior; and the effect of disease-management interventions on disease prevalence/severity. The effects of other mixed interventions on other health outcomes, including knowledge, self-efficacy, adherence, and quality of life, and costs were mixed; thus, the strength of evidence was insufficient. CONCLUSIONS: The field of health literacy has advanced since the 2004 report. Future research priorities include justifying appropriate cutoffs for health literacy levels prior to conducting studies; developing tools that measure additional related skills, particularly oral (spoken) health literacy; and examining mediators and moderators of the effect of health literacy. Priorities in advancing the design features of interventions include testing novel approaches to increase motivation, techniques for delivering information orally or numerically, "work around" interventions such as patient advocates; determining the effective components of already-tested interventions; determining the cost-effectiveness of programs; and determining the effect of policy and practice interventions
Member of
Additional physical form
Issued also in print.
Cataloging source
DNLM
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • surveys of literature
NLM call number
  • W1
  • WA 590
NLM item number
EV281 no.199 2011
http://library.link/vocab/relatedWorkOrContributorName
  • Berkman, Nancy D
  • United States
  • RTI International-University of North Carolina Evidence-based Practice Center
Series statement
  • Evidence report/technology assessment
  • AHRQ publication
Series volume
  • no. 199
  • no. 11-E006
http://library.link/vocab/subjectName
  • Health Literacy
  • Outcome Assessment (Health Care)
  • Healthcare Disparities
Label
Health literacy interventions and outcomes : an updated systematic review, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI International-University of North Carolina Evidence-based Practice Center ; investigators, Nancy D. Berkman ... [et al.], (electronic resource)
Instantiates
Publication
Note
  • "Contract No. 290-2007-10056-I."
  • "March 2011."
Bibliography note
Includes bibliographical references
Dimensions
unknown
Extent
1 online resource (1 PDF file (1 v. (various pagings)
Form of item
online
Other physical details
ill.)
Specific material designation
remote
System control number
  • 1581891
  • (DNLM)BKSHLF:NBK82434
Label
Health literacy interventions and outcomes : an updated systematic review, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI International-University of North Carolina Evidence-based Practice Center ; investigators, Nancy D. Berkman ... [et al.], (electronic resource)
Publication
Note
  • "Contract No. 290-2007-10056-I."
  • "March 2011."
Bibliography note
Includes bibliographical references
Dimensions
unknown
Extent
1 online resource (1 PDF file (1 v. (various pagings)
Form of item
online
Other physical details
ill.)
Specific material designation
remote
System control number
  • 1581891
  • (DNLM)BKSHLF:NBK82434

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