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Table 4 Summary of health literacy and behavioural outcome results

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

Reference, 1st author, year, country

Health Literacy

Behavioural outcomes

Significant result found?

Summary result

Behavioural outcome measured

Significant result found?

Summary result

Domain

Health Care

  [30] Calderon, 2014 USA

Yes

I > C: p = 0.03

None

  [31] Tai, 2016 USA

Yes

After adjusting for pre-score, I > C: p = 0.011

None

  [32] Gharachourlo, 2018 Iran

Yes

I > C: p < 0.001

10 dimensions of health, physical health, sports and fitness, weight management and nutrition, disease prevention, mental health, spiritual health, social health, avoidance of drugs, alcohol and opiates, accident prevention and environmental health.

Yes for 8/10 dimensions (not environmental health and spiritual health)

I > C: p < 0.001 (Overall lifestyle, physical health, sports & fitness, weight management & nutrition, disease prevention, mental health, social health, avoidance of drugs, alcohol and opiates, accident prevention)

  [33] Knudsen, 2019 Denmark

For HLQ6 only

HLQ6: I > C p = 0.003

None

  [34] Tavakoly Sany, 2019 Iran

Yes

I > C: p < 0.05

Self-care behaviours for heart failure

Yes

I > C: p < 0.05

  [35] Banbury, 2020 Australia

No

I vs C: p > 0.05

None

  [36] Handa, 2020 Japan

No

I vs C: p > 0.05

None

  [37] Kim. 2020 USA

Yes

REALM: I > C: 3, 6 months p < 0.01, 12 months p < 0.001

DM-REALM: I > C: 3,6,12 months p < 0.001

TOFHLA: I > C: 3 months p < 0.05

NVS: I > C: 3,6,12 months p < 0.05

None

Domain

Disease prevention

  [38] Li 2016, Niger

Yes

I > C: p < 0.01

None

  [39] Han, 2017 USA

Yes

HL change T1 to T2 I > C (p < .05)

Self-reported mammogram at baseline and medical record review at post-test

Yes

I > C, OR 18.5 (95% confidence interval [CI] = 9.2, 37.4)

Self-reported pap test at baseline and medical record review at post-test

Yes

I > C, OR 13.3 (95% CI = 7.9, 22.3)

Self-reported mammogram and pap test at baseline and medical record review at post-test

Yes

I > C, OR 17.4 (95% CI = 7.5, 40.3)

Domain

Health promotion

  [40] Otilingam 2015, USA

Yes

(Combined intervention groups) I > C: p = 0.0103.

HL change T1 to T2 I > C: 0.039

HL change T1 to T3 n.s

Behaviours to reduce dietary fats

Yes

T1 to T3 I > C: p = 0.0140.

  [41] Zhuang, 2016 China

Yes

I > C: p < 0.001

None

  [42] Mas, 2017 USA

No

I vs C: p > 0.05

None

  [43] Parekh, 2017 USA

No

I vs C: p > 0.05

Nutrition literacy

No

I vs C: p > 0.05

Fruit and vegetable intake

No

I vs C: p > 0.05

  [44] Liu, 2018 China

Yes

I > C: p < 0.05

None

  [45, 46] Mas, 2018 (and 2015) USA

Yes

Change score I > C: p = 0.01

34 item questionnaire measuring nutrition & physical activity behaviours

Yes, in adjusted model

I > C: p = 0.049.

  [47] Panahi, 2018 Iran

Yes

HL change T1 –T2 -T3 I > C: p = 0.014

Smoking behaviour

Yes

I > C: p < 0.0001

  [48] Tsai, 2018 Taiwan

No

I vs C: p > 0.05

None

  [49] Uemura, 2018 Japan

For some but not all domains

HLS-EU-Q16 I > C: disease prevention score p = 0.04

HLS-14 I > C: Total score p = 0.03, Communicative score p = 0.01, critical score, p = 0.02

Dietary habits – food frequency

Yes

I > C p = 0.001

Dietary habits – dietary variety

Yes

I > C p = 0.04

Steps per day

Yes

I > C: p < 0.001

Total energy expenditure (physical activity level x basal metabolic rate)

Yes

I > C: p = 0.01

  [50] Fiedler, 2019 Germany

Mixed and inconclusive

A significant effect was only seen for proactive help for the intervention group at T1.

None

  [51] McCaffery 2019, Australia

HLQ3 only

HLQ3: I > C p = 0.01

None

  [52] Smith, 2019 Australia

No

I vs C: p > 0.05

None

  1. Note: I Intervention, C Control