Community-based initiatives improving critical health literacy: a systematic review and meta-synthesis of qualitative evidence

Abstract

BackgroundCritical health literacy enables older adults to make informed health decisions and take actions for the health and wellbeing of themselves and their community, within their own social and cultural context. A community-based approach has the potential to improve the critical health literacy of older adults and their communities. However, it is not clear how such initiatives consider critical health literacy. Therefore, this study explored how community-based initiatives address the critical health literacy of older adults and their communities.MethodsA systematic literature search was conducted. Two reviewers independently screened titles and abstracts, as well as the quality of the methodological and community-based elements of the studies. In addition, a meta-synthesis was carried out, consisting of a qualitative text analysis of the results sections of the 23 included studies.ResultsWe identified two main themes, which are practices that contribute to the critical health literacy of older adults as well as their communities: 1) collaborative learning, and 2) social support. In these practices we identified reciprocity as a key characteristic of both co-learning and social support.ConclusionsThis study provides the first overview of community-based initiatives that implicitly address the critical health literacy of older adults and their community. Our results demonstrate that in the context of one’s own life collaborative learning and social support could contribute to people’s understanding and ability to judge, sift and use health information. We therefore suggest to add these two practices to the definition of critical health literacy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4570-7) contains supplementary material, which is available to authorized users.

Health Literacy: From a Property of Individuals to One of Communities

“…However, from the standpoint of existing HL interventions targeting communities we found in the literature, the community is either understood as a setting (a place outside of the medical clinics) or as an aggregate of individuals [35,36]. Similarly to De Wit et al [42], we found that the focus of these studies was mainly on vulnerable populations such as migrant groups [43] and older people [35].…”

Re-thinking health literacy: using a capabilities approach perspective towards realising social justice goals

“…skills and competencies, the outcomes of interest within current health literacy approaches, to capture the capabilities of value that allow individuals and communities to be health literate (see Robeyn's methodological process 39,49). Research that explores what individuals and communities consider important components of health literacy (5,33,47,57), and emphasises the role of social support, learning within social groups, culture, and social networks (e.g. 33,47) Participatory community approaches therefore are a good way to bring together the capabilities approach and health literacy fields as both have successfully utilised these methods.…”

“…Research that explores what individuals and communities consider important components of health literacy (5,33,47,57), and emphasises the role of social support, learning within social groups, culture, and social networks (e.g. 33,47) Participatory community approaches therefore are a good way to bring together the capabilities approach and health literacy fields as both have successfully utilised these methods. Critical health literacy researchers have placed community participatory approaches at the centre of health literacy research and implementation.…”

Media Health Literacy, eHealth Literacy, and the Role of the Social Environment in Context

“…Several studies have researched this assumption, with interesting results. For example, de Wit and colleagues [60] conducted a metaanalysis showing that social support and co-learning in communities were essential for critical health literacy based on qualitative evidence.…”