Effect of health literacy interventions on pregnancy outcomes: A systematic review |
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| Institution: | 1. The School of Medicine, The University of Notre Dame, Australia;2. The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, Australia;3. The University of Sydney, Charles Perkins Centre, Australia;4. The University of Sydney, Faculty of Medicine and Health, Central Clinical School, Australia;5. Royal Prince Alfred Newborn Care, Royal Prince Alfred Hospital, Sydney, Australia;1. Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands;2. Department of Society Studies, Faculty of Arts and Social Sciences, Maastricht University, Maastricht, The Netherlands;3. CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands;1. Department of Management Studies, School of Business and Law, University for Development Studies, Wa Campus, Ghana;2. Nottingham University Business School, Jubilee Campus, Nottingham, NG8 1BB, UK;3. Department of Planning, Faculty of Planning and Land Management, University for Development Studies, Wa Campus, Ghana;1. Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, UK;2. Richard Bright Renal Service, North Bristol National Health Service Trust, Bristol, UK;3. Department of Surgery, University of Cambridge, and National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge, UK;4. Health Psychology Research Unit, Royal Holloway, University of London, London, UK;5. Warwick Medical School, University of Warwick, Warwick, UK;6. Belfast Health and Social Care Trust, Belfast, UK;7. National Health Service Blood and Transplant, Bristol, UK;8. Scottish Renal Registry, City, UK;9. Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, UK;10. Department of Renal Medicine, Freeman Hospital, Newcastle-upon Tyne, UK;1. Cardiovascular Prevention and Rehabilitation Program, University Health Network, Toronto Rehabilitation Institute, Toronto, Canada;2. Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, Brazil |
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| Abstract: | BackgroundLow health literacy has been associated with worse health outcomes, but little is known about the effectiveness of health literacy interventions developed for pregnant women.AimTo assess the effectiveness of health literacy interventions on pregnancy outcomes through a systematic review of randomised controlled trials.MethodsRandomised controlled trials that assessed health literacy interventions designed to improve pregnancy outcomes were included. The study protocol was registered with PROSPERO (CRD42018094958).FindingsOf 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.DiscussionFew 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.ConclusionMore 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. |
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| Keywords: | Pregnancy Health literacy Systematic review Interventions |
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