Michael Pignone|Darren A. DeWalt|Stacey Sheridan|Nancy D Berkman|Kathleen N Lohr
Interventions to improve health outcomes for patients with low literacy
University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|RTI International|RTI International
perform systematic review interventions designed improve health outcomes persons low literacy skillswe searched medline cumulative index nursing allied health cinahl educational resources information center eric public affairs information service pais industrial labor relations review illr psycinfo ageline 1980 2003we included controlled uncontrolled trials measured literacy examined effect interventions people low literacy health outcomes including health knowledge health behaviors use health care resources intermediate markers disease status measures morbidity mortality two abstractors reviewed study inclusion disagreements resolved consensus among research teamone reviewer abstracted data article evidence table second reviewer checked entry disagreements information evidence tables resolved team consensus data extractors independently completed 11item quality scale article scores averaged give final measure article qualitywe identified 20 articles examining interventions designed improve health among people low literacy common outcome studied health knowledge fewer studies examined health behaviors intermediate markers measures disease prevalence severity effectiveness interventions appeared mixed limitations research quality heterogeneity outcome measures make drawing firm conclusions effective strategies difficult 5 articles examined interaction literacy level effect intervention also found mixed resultsseveral interventions developed improve health people low literacy limitations study design interventions tested outcomes assessed make drawing conclusions effectiveness difficult research required understand better types interventions effective efficient overcoming literacyrelated barriers good health