The School of Medicine, The University of Notre Dame, Australia.
The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, Australia.
Women Birth. 2021 Mar;34(2):180-186. doi: 10.1016/j.wombi.2020.01.010. Epub 2020 Feb 21.
Low health literacy has been associated with worse health outcomes, but little is known about the effectiveness of health literacy interventions developed for pregnant women.
To assess the effectiveness of health literacy interventions on pregnancy outcomes through a systematic review of randomised controlled trials.
Randomised controlled trials that assessed health literacy interventions designed to improve pregnancy outcomes were included. The study protocol was registered with PROSPERO (CRD42018094958).
Of the 1512 records initially identified, 13 studies were included. Three reported on decision-aid interventions, six on face-to-face interventions and four on written interventions (including computer-based interventions or information leaflets). The primary outcomes of interest for this systematic review were knowledge (10/13 studies) and health literacy (2/13 studies) with one study not reporting either primary outcome. A significant improvement in knowledge was found across the 10 studies, however the two studies which measured health literacy only assessed health literacy at a single time-point. Secondary outcomes including health behaviours, fetal outcomes and health-service utilisation were reported in 11 studies, with inconsistent results.
Few health literacy interventions have been developed specifically for pregnant women. Although health literacy interventions have the potential to improve knowledge and pregnancy outcomes, current evidence is limited by inconsistent outcomes and measurement, and limited use of health literacy theory to inform intervention design and content. Few studies directly measured health literacy.
More research is needed to properly assess the effect of health literacy interventions on pregnancy outcomes. This research should include consideration of health literacy theory in the development of the interventions.
低健康素养与较差的健康结果相关，但对于针对孕妇开发的健康素养干预措施的有效性知之甚少。
通过系统评价随机对照试验来评估健康素养干预措施对妊娠结局的有效性。
纳入评估旨在改善妊娠结局的健康素养干预措施的随机对照试验。该研究方案在 PROSPERO（CRD42018094958）中进行了注册。
最初确定的 1512 条记录中，有 13 项研究被纳入。其中 3 项报告了决策辅助干预措施，6 项报告了面对面干预措施，4 项报告了书面干预措施（包括基于计算机的干预措施或信息传单）。本系统评价的主要结局是知识（10/13 项研究）和健康素养（2/13 项研究），其中一项研究未报告任何主要结局。10 项研究均发现知识显著提高，但仅评估健康素养的两项研究仅在一个时间点评估健康素养。11 项研究报告了包括健康行为、胎儿结局和卫生服务利用在内的次要结局，但结果不一致。
很少有专门针对孕妇的健康素养干预措施。尽管健康素养干预措施有可能改善知识和妊娠结局，但目前的证据受到结果不一致和测量、以及健康素养理论在干预设计和内容中的应用有限的限制。很少有研究直接测量健康素养。
需要更多的研究来正确评估健康素养干预措施对妊娠结局的影响。这项研究应在干预措施的开发中考虑健康素养理论。
