Cochrane · systematic review · CD013303
Interventions for improving health literacy in migrants
Baumeister, A, Aldin, A, Chakraverty, D, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
Consumers and CommunicationAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
81
current version
GRADE rated
38
No studies
43
Included studies
NR
No studies 43 · 53.1%Ungraded 0 · 0%Very low 8 · 9.9%Low 18 · 22.2%Moderate 12 · 14.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Culturally and literacy adapted self‐management programme versus no health literacy intervention
Population: migrants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome category – outcome(s)* Culturally and literacy adapted self‐management programme vs no health literacy intervention | no estimate extracted | NR | No studies |
Health literacy – Disease‐specific health literacy Culturally and literacy adapted self‐management programme vs no health literacy intervention | no estimate extracted | 1 study · 69 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Culturally and literacy adapted self‐management programme vs no health literacy intervention | no estimate extracted | NR | No studies |
Health‐related knowledge – Multiple measures used: (1)Diabetes knowledge subset of ADKnowl, adapted version, score Culturally and literacy adapted self‐management programme vs no health literacy intervention | no estimate extracted | 2 studies · 321 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health outcome – Self‐reported health status Culturally and literacy adapted self‐management programme vs no health literacy intervention | no estimate extracted | 1 study · 69 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health behaviour 5– Time point a: short‐term (immediately post‐intervention) Multiple outcomes assessed and multiple measures used: (1) Blood glucose self‐monitoring 24‐hour recall, 3 questions on blood glucose self‐monitoring behaviour (2) Adhere... Culturally and literacy adapted self‐management programme vs no health literacy intervention | no estimate extracted | 3 studies · 514 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Self‐efficacy – Self‐efficacy to manage one's disease Multiple measures used: LSESLD (score Culturally and literacy adapted self‐management programme vs no health literacy intervention | no estimate extracted | 2 studies · 333 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Health service use – not measured Culturally and literacy adapted self‐management programme vs no health literacy intervention | no estimate extracted | NR | No studies |
Adverse events – not reported Culturally and literacy adapted self‐management programme vs no health literacy intervention | no estimate extracted | NR | No studies |
Culturally and literacy adapted self‐management programme versus written information on the same topic
Population: migrants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome category – outcome(s)* Culturally and literacy adapted self‐management programme vs written information on the same topic | no estimate extracted | NR | No studies |
Health literacy – Time point a: short‐term (immediately post‐intervention)*** (1) Any generic health literacy Multiple outcomes assessed and multiple measures used: Health numeracy (NVS, score Culturally and literacy adapted self‐management programme vs written information on the same topic | no estimate extracted | 1 study · 209 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of life – Diabetes‐related quality of life standardised on score 0 (no quality of life) to 100 (perfect quality of life) Time point: short‐term (immediately post‐intervention) Culturally and literacy adapted self‐management programme vs written information on the same topic | no estimate extracted | 2 studies · 288 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Health‐related knowledge – Time point a: short‐term (immediately post‐intervention) Any health‐related knowledge standardised on score 0 (no knowledge) to 100 (perfect knowledge) Time point b: medium‐term (up to 6 months post‐intervention) Any hea... Culturally and literacy adapted self‐management programme vs written information on the same topic | no estimate extracted | 4 studies · 1101 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health outcome – Any depression Time point a: short‐term (immediately post‐intervention) Multiple measures used: PHQ‐9K (score Culturally and literacy adapted self‐management programme vs written information on the same topic | no estimate extracted | 3 studies · 555 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Health behaviour – Multiple outcomes assessed and multiple measures used Time point a: short‐term (immediately post‐intervention) (1) Diabetes self‐care activities SDSCA (score Culturally and literacy adapted self‐management programme vs written information on the same topic | no estimate extracted | 2 studies · 797 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Self‐efficacy – Self‐efficacy to manage one's disease Time point a: short‐term (immediately post‐intervention) Multiple measures used: Adapted Stanford Chronic Disease Self‐Efficacy Scale (score Culturally and literacy adapted self‐management programme vs written information on the same topic | no estimate extracted | 4 studies · 552 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Health service use – not reported Culturally and literacy adapted self‐management programme vs written information on the same topic | no estimate extracted | NR | No studies |
Adverse events – not reported Culturally and literacy adapted self‐management programme vs written information on the same topic | no estimate extracted | NR | No studies |
Culturally adapted health literacy skills building course versus no/unrelated health literacy intervention
Population: migrants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome category – outcome(s)* Culturally adapted health literacy skills building course vs no/unrelated health literacy intervention | no estimate extracted | NR | No studies |
Health literacy – Time point a: short‐term (up to 1 month post‐intervention)*** (1) Any generic functional health literacy Multiple measures used: TOFHLA (score range 0 to 100) NVS (score range 0 to 6) Higher score is better (2) Disease‐specific h... Culturally adapted health literacy skills building course vs no/unrelated health literacy intervention | no estimate extracted | 2 studies · 229 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life – not measured Culturally adapted health literacy skills building course vs no/unrelated health literacy intervention | no estimate extracted | NR | No studies |
Health‐related knowledge – Time point a: short‐term (up to 1 month post‐intervention) Any health‐related knowledge standardised on score 0 (no knowledge) to 100 (perfect knowledge) Time point b: medium‐term (6 months post‐intervention) Multiple me... Culturally adapted health literacy skills building course vs no/unrelated health literacy intervention | no estimate extracted | 2 studies · 111 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health outcome – not measured Culturally adapted health literacy skills building course vs no/unrelated health literacy intervention | no estimate extracted | NR | No studies |
Health behaviour – Time point a: short‐term (up to 1 month post‐intervention) Multiple outcomes assessed and multiple measures used: (1) Fat‐related dietary habits Fat‐Related Diet Habits Questionnaire (score Culturally adapted health literacy skills building course vs no/unrelated health literacy intervention | no estimate extracted | 2 studies · 229 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Self‐efficacy – Self‐efficacy to change one's diet Culturally adapted health literacy skills building course vs no/unrelated health literacy intervention | no estimate extracted | 1 study · 290 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Health service use – not reported Culturally adapted health literacy skills building course vs no/unrelated health literacy intervention | no estimate extracted | NR | No studies |
Adverse events – not reported Culturally adapted health literacy skills building course vs no/unrelated health literacy intervention | no estimate extracted | NR | No studies |
Culturally and literacy adapted telephone education versus unrelated health literacy intervention
Population: migrants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome category – outcome(s)* Culturally and literacy adapted telephone education vs unrelated health literacy intervention | no estimate extracted | NR | No studies |
Health literacy – (1) Appraising health information Culturally and literacy adapted telephone education vs unrelated health literacy intervention | no estimate extracted | 1 study · 431 participants | Moderate Downgraded: imprecision |
Quality of life – not measured Culturally and literacy adapted telephone education vs unrelated health literacy intervention | no estimate extracted | NR | No studies |
Health‐related knowledge – Prostate cancer knowledge Standardised on score 0 (no knowledge) to 100 (perfect knowledge) Time point: long‐term (approx. 7 months post‐intervention) Culturally and literacy adapted telephone education vs unrelated health literacy intervention | no estimate extracted | 1 study · 431 participants | Moderate Downgraded: imprecision |
Health outcome – not measured Culturally and literacy adapted telephone education vs unrelated health literacy intervention | no estimate extracted | NR | No studies |
Health behaviour – PSA testing Culturally and literacy adapted telephone education vs unrelated health literacy intervention | RR 0.93 [0.82, 1.07] | 1 study · 490 participants | Moderate Downgraded: imprecision |
Self‐efficacy – not measured Culturally and literacy adapted telephone education vs unrelated health literacy intervention | no estimate extracted | NR | No studies |
Health service use – not measured Culturally and literacy adapted telephone education vs unrelated health literacy intervention | no estimate extracted | NR | No studies |
Adverse events – Anxiety Culturally and literacy adapted telephone education vs unrelated health literacy intervention | no estimate extracted | 1 study · 431 participants | Moderate Downgraded: imprecision |
Culturally and literacy adapted audio‐/visual education without personal feedback versus no health literacy intervention
Population: migrants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome category – outcome(s)* Culturally and literacy adapted audio‐/visual education without personal feedback vs no health literacy intervention | no estimate extracted | NR | No studies |
Health literacy – (1) Depression literacy Culturally and literacy adapted audio‐/visual education without personal feedback vs no health literacy intervention | no estimate extracted | 1 study · 202 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of life – not measured Culturally and literacy adapted audio‐/visual education without personal feedback vs no health literacy intervention | no estimate extracted | NR | No studies |
Health‐related knowledge – Any health‐related knowledge standardised on score 0 (no knowledge) to 100 (perfect knowledge) Time point: short‐term (up to 1 month post‐intervention) Culturally and literacy adapted audio‐/visual education without personal feedback vs no health literacy intervention | no estimate extracted | 2 studies · 293 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health outcome ‐ Depression Multiple measures used: PHQ‐8 (score Culturally and literacy adapted audio‐/visual education without personal feedback vs no health literacy intervention | no estimate extracted | 2 studies · 337 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health behaviour – Child's up‐to‐date immunisation Culturally and literacy adapted audio‐/visual education without personal feedback vs no health literacy intervention | RR 1.07 [0.91, 1.25] | 1 study · 135 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Self‐efficacy – Self‐efficacy to identify need for treatmentfor depression Culturally and literacy adapted audio‐/visual education without personal feedback vs no health literacy intervention | no estimate extracted | 1 study · 133 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health service use – Child's emergency room visits Culturally and literacy adapted audio‐/visual education without personal feedback vs no health literacy intervention | no estimate extracted | 1 study · 157 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Adverse events – not measured Culturally and literacy adapted audio‐/visual education without personal feedback vs no health literacy intervention | no estimate extracted | NR | No studies |
Culturally and literacy adapted audio‐/visual education without personal feedback versus written information on the same topic
Population: migrants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome category – outcome(s)* Culturally and literacy adapted audio‐/visual education without personal feedback vs written information on the same topic | no estimate extracted | NR | No studies |
Health literacy – Time point a: short‐term (up to 1 month post‐intervention)*** (1) Diabetes health literacy Culturally and literacy adapted audio‐/visual education without personal feedback vs written information on the same topic | no estimate extracted | 1 study · 240 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of life – not measured Culturally and literacy adapted audio‐/visual education without personal feedback vs written information on the same topic | no estimate extracted | NR | No studies |
Health‐related knowledge – Time point a: short‐term (up to 1 month post‐intervention) Any health‐related knowledgeStandardised on score 0 (no knowledge) to 100 (perfect knowledge) Time point b: medium‐term (up to 6 months post‐intervention) Any he... Culturally and literacy adapted audio‐/visual education without personal feedback vs written information on the same topic | no estimate extracted | 3 studies · 987 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health outcome – Depression Culturally and literacy adapted audio‐/visual education without personal feedback vs written information on the same topic | no estimate extracted | 1 study · 445 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health behaviour – Time point a: medium‐term (up to 6 months post‐intervention) Any cancer screening uptake Culturally and literacy adapted audio‐/visual education without personal feedback vs written information on the same topic | RR 1.07 [0.95, 1.2] | 2 studies · 803 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Self‐efficacy – Time point a: short‐term (immediately post‐intervention) Self‐efficacy in accessing breast cancer‐related advice or information Culturally and literacy adapted audio‐/visual education without personal feedback vs written information on the same topic | no estimate extracted | 1 study · 240 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health service use – not measured Culturally and literacy adapted audio‐/visual education without personal feedback vs written information on the same topic | no estimate extracted | NR | No studies |
Adverse events – Anxiety Culturally and literacy adapted audio‐/visual education without personal feedback vs written information on the same topic | no estimate extracted | 1 study · 445 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Culturally and literacy adapted audio‐/visual education without personal feedback versus another culturally and literacy adapted audio‐/visual education without personal feedback
Population: migrants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome category – outcome(s)* Culturally and literacy adapted audio‐/visual education without personal feedback vs another culturally and literacy adapted audio‐/visual education without personal feedback | no estimate extracted | NR | No studies |
Health literacy – (1) Competencies (inhaler use technique) Culturally and literacy adapted audio‐/visual education without personal feedback vs another culturally and literacy adapted audio‐/visual education without personal feedback | no estimate extracted | 2 studies · 91 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Quality of life – not measured Culturally and literacy adapted audio‐/visual education without personal feedback vs another culturally and literacy adapted audio‐/visual education without personal feedback | no estimate extracted | NR | No studies |
Health‐related knowledge – Any health‐related knowledge Cervical cancer knowledge; standardised on score from 0 (no knowledge) to 100 (perfect knowledge) Asthma knowledge, 3 items, 5‐point Likert scale (score Culturally and literacy adapted audio‐/visual education without personal feedback vs another culturally and literacy adapted audio‐/visual education without personal feedback | no estimate extracted | 2 studies · 152 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Health outcome – not measured Culturally and literacy adapted audio‐/visual education without personal feedback vs another culturally and literacy adapted audio‐/visual education without personal feedback | no estimate extracted | NR | No studies |
Health behaviour – Cervical cancer screening Culturally and literacy adapted audio‐/visual education without personal feedback vs another culturally and literacy adapted audio‐/visual education without personal feedback | RR 1.29 [0.75, 2.23] | 1 study · 109 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Self‐efficacy – not measured Culturally and literacy adapted audio‐/visual education without personal feedback vs another culturally and literacy adapted audio‐/visual education without personal feedback | no estimate extracted | NR | No studies |
Health service use – not measured Culturally and literacy adapted audio‐/visual education without personal feedback vs another culturally and literacy adapted audio‐/visual education without personal feedback | no estimate extracted | NR | No studies |
Adverse events – not measured Culturally and literacy adapted audio‐/visual education without personal feedback vs another culturally and literacy adapted audio‐/visual education without personal feedback | no estimate extracted | NR | No studies |
Culturally and literacy adapted medical instruction versus no health literacy intervention
Population: migrants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome category – outcome(s)* Culturally and literacy adapted medical instruction vs no health literacy intervention | no estimate extracted | NR | No studies |
Health literacy – Medication understanding Multiple measures used: Demonstration by means of correct dosage in dosing tray (0 to 5) Correct interpretation of label contents, 11 labels MUQ (score Culturally and literacy adapted medical instruction vs no health literacy intervention | no estimate extracted | 3 studies · 478 participants | Low Downgraded: risk of bias, imprecision |
Quality of life – not measured Culturally and literacy adapted medical instruction vs no health literacy intervention | no estimate extracted | NR | No studies |
Health outcome – not measured Culturally and literacy adapted medical instruction vs no health literacy intervention | no estimate extracted | NR | No studies |
Health‐related knowledge – not measured Culturally and literacy adapted medical instruction vs no health literacy intervention | no estimate extracted | NR | No studies |
Health behaviour – Medication adherence Culturally and literacy adapted medical instruction vs no health literacy intervention | no estimate extracted | 1 study · 200 participants | Low Downgraded: risk of bias, imprecision |
Health service use – not measured Culturally and literacy adapted medical instruction vs no health literacy intervention | no estimate extracted | NR | No studies |
Self‐efficacy ‐ not measured Culturally and literacy adapted medical instruction vs no health literacy intervention | no estimate extracted | NR | No studies |
Adverse events – not measured Culturally and literacy adapted medical instruction vs no health literacy intervention | no estimate extracted | NR | No studies |
Female migrants' benefit of any health literacy intervention versus male migrants' benefit of any health literacy intervention
Population: migrants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome category– outcome(s) Female migrants' benefit of any health literacy intervention vs male migrants' benefit of any health literacy intervention | no estimate extracted | NR | No studies |
Health literacy – Multiple outcomes and measures used: (1) Generic health literacy Functional health literacy, TOFHLA (score Female migrants' benefit of any health literacy intervention vs male migrants' benefit of any health literacy intervention | no estimate extracted | 1 study · 77 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life – not measured Female migrants' benefit of any health literacy intervention vs male migrants' benefit of any health literacy intervention | no estimate extracted | NR | No studies |
Health‐related knowledge – not measured Female migrants' benefit of any health literacy intervention vs male migrants' benefit of any health literacy intervention | no estimate extracted | NR | No studies |
Health outcome – not measured Female migrants' benefit of any health literacy intervention vs male migrants' benefit of any health literacy intervention | no estimate extracted | NR | No studies |
Health behaviour – Time point a: short‐term (immediately post‐intervention) Cardiovascular health behaviour CSC (score Female migrants' benefit of any health literacy intervention vs male migrants' benefit of any health literacy intervention | no estimate extracted | 1 study · 77 participants | Very low Downgraded: risk of bias, imprecision |
Health service use – not measured Female migrants' benefit of any health literacy intervention vs male migrants' benefit of any health literacy intervention | no estimate extracted | NR | No studies |
Self‐efficacy – not measured Female migrants' benefit of any health literacy intervention vs male migrants' benefit of any health literacy intervention | no estimate extracted | NR | No studies |
Adverse events – not measured Female migrants' benefit of any health literacy intervention vs male migrants' benefit of any health literacy intervention | no estimate extracted | NR | No studies |