Health literacy training for older adults: a systematic review with meta-analysis

Limited health literacy constitutes a global challenge that particularly affects the older population, compromising the ability to access, understand and use health information. Various intervention strategies have been developed to improve the understanding, processing, assessment, and application of health information, favoring better self-care practices among older people. To identify health literacy intervention models and investigate the effects on health outcomes as well as health literacy in older adults. A systematic review with meta-analysis was conducted. The protocol was registered in the PROSPERO database (CRD42024524874). Fifteen of the 18 articles included found an increase in health literacy after the intervention. Heterogeneity was identified among the studies due to the use of various instruments for the assessment of outcomes and different intervention formats. However, most interventions involved multiple meetings and were conducted in groups, encompassing multi-component activities that promoted participation, dialogue, and the exchange of experiences among the participants. Communication and access to health information were the most addressed subjects in the interventions. The results of the meta-analysis of nine articles revealed that the interventions had positive impacts on health literacy both in the comparison between the pre- and post-intervention assessments and the comparison to the control group. Other outcomes were also positively impacted by the health literacy interventions, such as quality of life, health behaviors, self-care, self-efficacy, and depressive symptoms. Despite the diversity of methods and absence of a standard model, the results indicate that health literacy interventions improve health literacy as well as other aspects of mental and physical health in older people.