Health literacy in clinical‐high‐risk individuals for psychosis: A systematic mixed‐methods review

Abstract

Objective Numerous studies suggest that health literacy (HL) plays a crucial role in maintaining and improving individual health. Empirical findings highlight the relation between levels of a person's HL and her/his clinical outcome. To date, the role of HL in persons at‐risk for psychosis has not been systematically reviewed. Methods We conducted a systematic review using a mixed‐methods approach to analyse a variety of study types. Peer‐reviewed publications were systematically searched in PUBMED, Cochrane Library, PsycINFO and Web of Science. Results The search string returned 10587 publications. After screening, 15 quantitative, four qualitative studies and two reviews were included. Only one study assessed HL as primary outcome, assessing knowledge and beliefs about psychosis among the general population. In the other studies, sub‐dimensions of HL were investigated. None of the publications operationalized HL or it's sub‐dimensions with a validated measure. Conclusions A lack of understanding of their condition, and fear of stigmatization, were associated with a delay in help‐seeking among people with clinical‐high‐risk state for psychosis. Family members, school personnel, general practitioners and the internet play a crucial role in the HL process. Considerable barriers in obtaining adequate specialist support emphasize the urgent need of a “HL environment” for persons at risk for psychosis.

Health Literacy as Communicative Action—A Qualitative Study among Persons at Risk in the Context of Predictive and Preventive Medicine

“…This allows taking into account strategical deliberations of persons at risk; depending on health-related future scenarios they were confronted with in the course of predictive procedures. The systematic reviews conducted in the first phase of the project provide an overview of the research landscape and current empirical evidence concerning the role of HL with respect to an increased risk in each of the four clinical fields; in addition, they revealed open questions and directions for future research [21][22][23] 2 .…”

A mixed‐method systematic literature review of health literacy interventions for people with disabilities

“…An ability to apply health‐related information involves two perspectives including using the information to make an informed decision about one's health and implementing the decisions to change or impact health behaviours (Haidl et al, 2019). Educational video decision aids promoted informed decision‐making on supportive kidney care if the disease progressed to the advanced stage for older people with CKD (Eneanya et al, 2020).…”

“…Critical health literacy should be stressed so individuals can assess the credibility and correctness of the information given that false and unsupported health information might pose a risk to their health (Nutbeam, 2008). Haidl et al (2019) stated that comprehensive insights into the four competencies in health literacy, (i.e., access, understand, appraise, apply) together are crucial to improve individuals' understanding of the process from the initial acquisition of information to action. Therefore, future research should examine a disabled participant's ability to access and appraise different types of health information, as well as the mechanisms in the overall process of transforming health information into action from access, to understand, to appraise and finally.…”

“…The Integrated Model of Health Literacy describes the core competencies including the ability to access, understand, appraise and apply. Each competency represents a crucial dimension of health literacy, as follows: (1) access describes the ability to seek, find and obtain health information; (2) understand describes the ability to comprehend the health information; (3) appraise refers to the ability to interpret or evaluate the health information and (4) apply describes the ability to use health information to make decisions and implement the information to change health behaviours (Haidl et al, 2019; Sørensen et al, 2012).…”