Systematic Review of Effective Determinants for Supporting Lifestyle Health Literacy in Primary Health Care (APHCRI)
Project Status
Completed
Project Coordinator
Mark Harris
Chief Investigators
Mark Harris
Associate Investigators
Anna Williams, Elizabeth Denney-Wilson, Sarah Dennis, Anthony Newall (School of Public Health and Community Medicine, UNSW), Tim Shortus, Jane Taggart, Nicholas Zwar
Rationale
This was a systematic review of the literature on effective interventions and drivers for health literacy in relation to the SNAP risk factors in primary health care, and the implications for practice and policy. It reported on the efficacy of specific interventions designed to improve health literacy in this area along with their impact in disadvantaged groups and facilitators barriers to their uptake. The report was been completed and publications are currently being prepared.
Aims
The study aimed to review the literature on the effectiveness of interventions to improve health literacy in the management of the SNAPW (Smoking, Nutrition, Alcohol, Physical Activity and Weight) lifestyle risk factors. This review addressed the following research questions:
1. What have been the major interventions nationally and internationally which have aimed to improve the health literacy and motivation of people to manage their own lifestyle risk factors?
a) Which of these interventions have been found to be effective in changing health literacy and the SNAPW lifestyle risk factors?
b) Evidence for the cost and/or cost-effectiveness of these interventions?
c) Which have been effective in different settings, with different providers, with different population groups?
d) Evidence for similarities and differences in low socio-economic groups and people with cultural or linguistic disadvantages?
2. What were the known effective drivers and barriers to the uptake and sustaining of the policy initiatives and interventions
a) Evidence for the cost-effectiveness of drivers to influence their uptake?
b) Evidence for similarities and differences in low socio-economic groups and people with cultural or linguistic disadvantages
c) What barriers influenced the uptake of these interventions in health services and health services providers
d) What barriers influenced the receptivity of patients to these interventions in primary health care?
3. What are the policy options to support the implementation of effective interventions to improve the knowledge, skills and motivation (health literacy) of people to manage their own lifestyle risk factors in Australian primary health care?
Design and Method
A systematic review of the published literature was conducted, including a review of published systematic reviews was undertaken with a focus on health literacy for changing the SNAPW behavioural risk factors in primary health care. We used a definition of health literacy which included basic and functional health literacy as well as more advanced interactive and critical health literacy. The review was preceded by consultations with a reference group and interviews with key stakeholders. The search strategy targeted a broad range of published materials including: peer reviewed journal literature, “grey” literature from electronic databases, websites of government and other agencies. In addition to this there was a targeted journal search and snowballing from reference lists of included studies.
Articles were screened by title and abstract and then verified by examining papers by two researchers and then those excluded were checked by a third researcher. A quality assessment was undertaken by two researchers to assess the methodological rigor of the studies. Papers were not excluded on quality but were graded high, medium and low based on quality scores.
From over four thousand papers initially identified, there were 54 studies which reported health literacy outcomes and/or SNAPW outcomes following a health literacy intervention. Other qualitative and descriptive studies were used to identify the drivers and barriers to health literacy for the behavioural risk factors.
Key Publications
Harris MF, Taggart J, Williams A, Dennis S, Newall A, Shortus T, Denney-Wilson E, Zwar N. Effective determinants for supporting lifestyle health literacy and self management skills in primary care. APHCRI 2010.
