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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