Valentina Baccolini|Annalisa Rosso|Carlo Di Paolo|Claudia Isonne|Carla Salerno|Giuseppe Migliara|GP Prencipe|Azzurra Massimi|Carolina Marzuillo|Corrado De Vito|Paolo Villari|Ferdinando Romano
What is the Prevalence of Low Health Literacy in European Union Member States? A Systematic Review and Meta-analysis
Harvard University|Sapienza University of Rome|Azienda Sanitaria Locale Roma 3|Sapienza University of Rome|Sapienza University of Rome|Sapienza University of Rome|Sapienza University of Rome|Sapienza University of Rome|Sapienza University of Rome|Sapienza University of Rome|Sapienza University of Rome|Sapienza University of Rome|Sapienza University of Rome|Sapienza University of Rome
abstract background many studies shown low health literacy hl associated several adverse outcomes study systematically reviewed prevalence low hl europe methods pubmed embase scopus searched crosssectional studies conducted european union eu published 2000 investigating prevalence low hl adults using reliable tool included quality assessed newcastleottawa scale inversevariance random effects methods used produce pooled prevalence estimates metaregression analysis performed assess association low hl characteristics studies results pooled prevalence low hl ranged 27 95 ci 1838 48 95 ci 4155 depending literacy assessment method applied southern western eastern eu countries lower hl compared northern europe 087 95 ci 040135 059 95 ci 025093 072 95 ci 006137 respectively assessment method significantly influenced pooled estimate compared word recognition items using selfreported comprehensions items 061 95 ci 015108 reading numeracy comprehensions items 077 95 ci 024131 mixed method 066 95 ci 001133 found higher rates low hl refugees lowest hl 159 95 ci 026292 finally lower quality studies reported higher rates low hl 056 95 ci 006107 discussion found low hl public health challenge throughout europe one every three almost one every two europeans may able understand essential healthrelated material additional research needed investigate underlying causes develop remedies prospero registration crd42019133377