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Table 1 Summary of studies

From: Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review

Reference, 1st author, year, country Study design Population: (Age, ethnic/migrant focus, n (f = %) Measure [Objective/Subjective] Health condition Domain Intervention content
[Total in-person contact timea (where applicable)]
Secondary Behavioural Outcomes measured
Domain Health Care
  [30] Calderon, 2014 USA RCT Adults,
Latino/Hispanic
240 (f = 81.66)
Diabetes Health Literacy Scale [Subjective] Diabetes Health care 13-min animation
[n/a]
None
  [31] Tai, 2016 USA RCT > 55
None
118
(f = 62.71)
STOFHLA [Objective] Taking 2 or more medications Health care A single one-to-one 10-min education session plus leaflets and sample labels for self-assessment
[10 min]
None
  [32] Gharachourlo, 2018 Iran RCT 18–35,
None,
100
(f = 100)
Iranian Health Literacy Questionnaire [Subjective] Gestational diabetes Health care Counselling with a health literacy approach (6 X 1.5 h weekly sessions)
[540 min]
Health lifestyle behaviours
  [33] Knudsen, 2019 Denmark Quasi-experimental Adults,
None,
77 (f = 9)
HLQ
[Subjective]
PCI, CABG, or left heart valve surgery Health care 12 weeks of supervised exercise training, dietary advice, educational sessions and psychosocial support
[unclear]
None
  [34] Tavakoly Sany, 2019 Iran RCT 30–75,
None,
80 (f = 73.75%)
TOFHLA
[Objective]
Heart failure Health care Three educational group workshops
[200 min]
Self-care behaviours
  [35] Banbury, 2020 Australia Quasi-experimental > 50,
None
111 (f = 64.86)
HLQ
[Subjective]
One or more chronic conditions Health care 5 facilitative learning video-conference self-management group sessions
[337.5 min]
None
  [36] Handa, 2020 Japan RCT Adults,
None
102 (f = 100)
HLS-14
[Subjective]
Breast cancer Health care Smartphone app for self-directed use to record symptoms and manage chemotherapy side-effects
[n/a]
None
  [37] Kim, 2020 USA RCT > 35,
Korean American
209 (f = 40.9)
REALM, DM-REALM, TOFHLA, NVS
[Objective]
Type 2 Diabetes Health care 6 × 2 h weekly education sessions, monthly motivational interviewing counselling sessions and daily self-monitoring of blood glucose levels
[1050 minb]
None
Domain Disease prevention
  [38] Li, 2016 Niger RCT Working age adults,
Chinese,
1441
(f = 2.98)
Malaria Health Literacy Questionnaire [Unclear] Malaria Disease prevention Malaria prevention and treatment messages via WeChat 3xweek for 4 months
[n/a]
None
  [39] Han, 2017 USA Cluster RCT 21–65,
Korean American,
560
(f = 100)
Assessment of health literacy in cancer screening [Objective] Cancer screening behaviours Disease prevention CHW provided education (Single 1.5–2-h small group session), monthly telephone counselling and navigation assistance over 6 months
[155 min]
Cancer screening
Domain Health promotion
  [40] Otilingam 2015, USA RCT > 40,
Latino,
100
(f = 100)
NVS [Objective] None Health promotion (nutrition) Two 2 h workshops (1 week apart) with culturally relevant nutrition education techniques and 3 behaviour change principles
[240 min]
Nutrition
  [41] Zhuang, 2016 China Cluster RCT Adults,
None
6413
(f = unknown)
RAHL [Objective] None Health promotion (general) Health education SMS message once a week for 1 year
[n/a]
None
  [42] Mas, 2017 USA Quasi-experimental 21 or over,
Hispanic,
97
(f = 81.44)
STOFHLA [Objective] None Health promotion (general) ESL curriculum (180 h) with HL content (5 × 2 h sessions)
[600 minc]
None
  [43] Parekh, 2017 USA Pilot RCT Adults,
None,
59
(f = 100)
NVS [Objective] Cancer survivors Health promotion (nutrition) 6 Small group nutrition education sessions (2 h duration) delivered fortnightly
[720 min]
Nutrition
  [44] Liu, 2018 China Cluster RCT 60 and above,
None,
260
(f = 49.23)
Chinese Citizen health literacy questionnaire
[Unclear]
None Health promotion (general) Teach back educational classes 40 min long once a month for 6 months
[240 min]
None
  [45, 46] Mas, 2018 (and 2015) USA RCT Adults,
Hispanic,
155
(f = 80.65)
TOFHLA [Objective] None Health promotion (general) ESL curriculum with HL content. 12 units over 6 weeks for total of 36 h (6 h sessions)
[2160 min]
Cardiovascular health behaviours
  [47] Panahi, 2018 Iran Cluster RCT University Students,
None,
130
(f = 60)
Health Literacy in Iranian Adults [Subjective] Smoking prevention Health promotion (smoking) Six educational sessions via telegram Social media application
[n/a]
Smoking
  [48] Tsai, 2018 Taiwan Quasi-experimental Adults,
Vietnamese/Indonesian
223
(f = 100)
Bespoke [Subjective] None Health promotion (general) 10 session (2 h per session) every other week, problem-based learning HL program
[1200 min]
None
  [49] Uemura, 2018 Japan RCT > 65,
None
84
(f = 70.23)
HLS-EU-Q16 and HLS-14 [Subjective] None Health promotion (nutrition and physical activity) Weekly 90-min active learning program for 24 weeks
[2160 min]
Nutrition and physical activity
  [50] Fiedler, 2019 Germany Crossover RCT Adults,
None
72
(f = 19.44)
German Health Literacy Questionnaire [Subjective] None Health promotion (general) 5-month training program. Three modules delivered over 3-day classroom training, peer coaching and practice material.
[1260 min]
None
  [51] McCaffery, 2019 Australia Cluster RCT > 16,
None,
213 (f = 70)
HLQ
[Subjective]
None Health promotion (general) 18 week health literacy focused adult education curriculum
[6480 min]
None
  [52] Smith, 2019 Australia RCT > 55,
None,
153 (f = 66.66)
HLQ
[Subjective]
None Health promotion (general) DVD/web based multi-media education on complementary medicine
[n/a]
None
  1. aIn-person contact time is calculated through description provided in the original paper. Number of sessions x duration of sessions gives total in-person contact time over the duration of the intervention. If a range is given (e.g. 1.5–2 h) then the midpoint is taken
  2. bThis reflects 720 min of group education sessions and an average of 30 min per counselling session for 11 months
  3. cThis reflects active health literacy content, but was embedded within a wider ESL intervention of 10,800 min