Jane Taggart|Anna Williams|Sarah Dennis|Anthony T. Newall|Tim Shortus|Nicholas Zwar|Elizabeth Denney?Wilson|Mark F Harris
A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors
UNSW Sydney|UNSW Sydney|UNSW Sydney|UNSW Sydney|UNSW Sydney|UNSW Sydney|UNSW Sydney|UNSW Sydney
evaluate effectiveness interventions used primary care improve health literacy change smoking nutrition alcohol physical activity weight snapwa systematic review intervention studies included outcomes health literacy snapw behavioral risk behaviors implemented primary care settingswe searched cochrane library johanna briggs institute medline embase cinahl psychinfo web science scopus apais australasian medical index google scholar community science four targeted journals patient education counseling health education behaviour american journal preventive medicine preventive medicinestudy inclusion criteria adults 18 years undertaken primary care setting within organisation economic cooperation development oecd country interventions least one measure health literacy promoting positive change smoking nutrition alcohol physical activity andor weight measure least one outcome associated health literacy report snapw outcome experimental quasiexperimental studies cohort observational controlled noncontrolled studiespapers assessed screened two researchers jt aw uncertain excluded studies reviewed third researcher mh data extracted included studies two researchers jt aw effectiveness studies quality assessed typology interventions thematically derived studies grouping snapw interventions six broad categories individual motivational interviewing counseling group education multiple interventions combination interventions written materials telephone coaching counseling computer web based interventions interventions classified intensity contact subjects high 8 points contacthours moderate 3 8 low 3 points contact hours setting primary health community otherstudies analyzed intervention category whether significant positive changes snapw health literacy outcomes reported52 studies included many different intervention types settings associated change health literacy 73 studies change snapw 75 studies low intensity interventions reported significant positive outcomes snapw 43 studies compared high intensity interventions 33 studies interventions primary health care community effective supporting smoking cessation whereas reverse true diet physical activity interventionsgroup individual interventions varying intensity primary health care community settings useful supporting sustained change health literacy change behavioral risk factors certain aspects risk behavior may better handled clinical settings others effectively community findings implications design programs