Institute of Sport and Exercise Medicine, Division of Orthopaedics, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
J Eval Clin Pract. 2021 Dec;27(6):1417-1428. doi: 10.1111/jep.13554. Epub 2021 Mar 22.
RATIONALE, AIMS AND OBJECTIVES: Health illiteracy is an important contributor to the burden of non-communicable diseases (NCDs); in particular in settings where health illiteracy is part of a perpetuating system of risk factors. Interventions that promote health literacy may provide an important tool in the primary and secondary prevention of NCDs. The objective of this systematic review was to evaluate the effectiveness of health literacy interventions on health literacy in the management of patients with selected NCDs living in low-to-middle income countries (LMIC).
Seven electronic databases were searched (October 29, 2020) for RCTs aimed at improving health literacy in adults with NCDs in LMICs. Eligible NCDs included those pertaining to cancer, cardiovascular disease (CVD), chronic respiratory disease (CRD) or Diabetes. Studies were included that explicitly focussed on improving health literacy, and reported comprehensive measures of health literacy, or components thereof (ie, knowledge, attitude or behaviour). Random-effect meta-analyses were conducted for continuous outcome measures (Hedges-g).
The completed search yielded 2573 unique results of which 53 unique studies met the inclusion criteria. Studies included patients with cancer (n = 1, 2%), CRD (n = 8, 15%), CVD (n = 11, 21%) or Diabetes (n = 33, 62%). A significant (P < .01) summary effect was found for disease knowledge (SES = 1.27 [n = 23, 95%CI = 1.05-1.49]), attitude (SES = 1.17 [n = 20, 95%CI = 0.88-1.47]), and behaviour (SES = 1.20 [n = 31, 95%CI = 0.94-1.46]).
These results support the conclusion that there is compelling evidence, in particular, for patients with Diabetes, that health-literacy interventions are effective in promoting disease knowledge, attitude and behaviour across four chronic conditions that drive the burden of NCDs.
背景、目的和目标：健康素养是导致非传染性疾病（NCD）负担的一个重要因素；特别是在健康素养是造成持续存在的危险因素的一部分的环境中。促进健康素养的干预措施可能是在中低收入国家（LMIC）中对 NCD 进行初级和二级预防的重要工具。本系统评价的目的是评估在 LMIC 中患有选定 NCD 的患者中进行健康素养干预对健康素养的有效性。
搜索了 7 个电子数据库（2020 年 10 月 29 日），以寻找针对 LMIC 中患有 NCD 的成年人提高健康素养的 RCT。合格的 NCD 包括癌症、心血管疾病（CVD）、慢性呼吸道疾病（CRD）或糖尿病。纳入的研究明确侧重于提高健康素养，并报告了健康素养的综合衡量指标，或其组成部分（即知识、态度或行为）。对连续结果测量（Hedges-g）进行了随机效应荟萃分析。
完成的搜索产生了 2573 个唯一结果，其中 53 个独特的研究符合纳入标准。研究包括癌症患者（n=1，2%）、CRD 患者（n=8，15%）、CVD 患者（n=11，21%）或糖尿病患者（n=33，62%）。发现疾病知识（SES=1.27[n=23，95%CI=1.05-1.49]）、态度（SES=1.17[n=20，95%CI=0.88-1.47]）和行为（SES=1.20[n=31，95%CI=0.94-1.46]）的综合效果有显著差异（P<0.01）。
这些结果支持这样的结论，即在特别是糖尿病患者中，健康素养干预措施在促进四种导致 NCD 负担的慢性疾病的疾病知识、态度和行为方面非常有效，这具有很强的证据支持。
