A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors
Tóm tắt
To evaluate the effectiveness of interventions used in primary care to improve health literacy for change in smoking, nutrition, alcohol, physical activity and weight (SNAPW). A systematic review of intervention studies that included outcomes for health literacy and SNAPW behavioral risk behaviors implemented in primary care settings. We searched the Cochrane Library, Johanna Briggs Institute, Medline, Embase, CINAHL, Psychinfo, Web of Science, Scopus, APAIS, Australasian Medical Index, Google Scholar, Community of Science and four targeted journals (Patient Education and Counseling, Health Education and Behaviour, American Journal of Preventive Medicine and Preventive Medicine). Study inclusion criteria: Adults over 18 years; undertaken in a primary care setting within an Organisation for Economic Co-operation and Development (OECD) country; interventions with at least one measure of health literacy and promoting positive change in smoking, nutrition, alcohol, physical activity and/or weight; measure at least one outcome associated with health literacy and report a SNAPW outcome; and experimental and quasi-experimental studies, cohort, observational and controlled and non-controlled before and after studies. Papers were assessed and screened by two researchers (JT, AW) and uncertain or excluded studies were reviewed by a third researcher (MH). Data were extracted from the included studies by two researchers (JT, AW). Effectiveness studies were quality assessed. A typology of interventions was thematically derived from the studies by grouping the SNAPW interventions into six broad categories: individual motivational interviewing and counseling; group education; multiple interventions (combination of interventions); written materials; telephone coaching or counseling; and computer or web based interventions. Interventions were classified by intensity of contact with the subjects (High ≥ 8 points of contact/hours; Moderate >3 and <8; Low ≤ 3 points of contact hours) and setting (primary health, community or other). Studies were analyzed by intervention category and whether significant positive changes in SNAPW and health literacy outcomes were reported. 52 studies were included. Many different intervention types and settings were associated with change in health literacy (73% of all studies) and change in SNAPW (75% of studies). More low intensity interventions reported significant positive outcomes for SNAPW (43% of studies) compared with high intensity interventions (33% of studies). More interventions in primary health care than the community were effective in supporting smoking cessation whereas the reverse was true for diet and physical activity interventions. Group and individual interventions of varying intensity in primary health care and community settings are useful in supporting sustained change in health literacy for change in behavioral risk factors. Certain aspects of risk behavior may be better handled in clinical settings while others more effectively in the community. Our findings have implications for the design of programs.
Tài liệu tham khảo
von Wagner C, Knight K, Steptoe A, Wardle J: Functional health literacy and health‒promoting behaviour in a national sample of British adults. J Epidemiology Community Health. 2007, 61: 1086-1090. 10.1136/jech.2006.053967.
De Walt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP: Literacy and Health Outcomes: A Systematic Review of the Literature. J Gen Intern Med. 2004, 19: 1228-1239. 10.1111/j.1525-1497.2004.40153.x.
Berkman ND PM, Sheridan SL, Lohr KN, Lux L, Sutton SF, Swinson T, Bonito AJ: Literacy and Health Outcomes: Evidence Report/Technology Assessment. Literacy and Health Outcomes: Evidence Report/Technology Assessment Agency for Healthcare Research and Quality. 2004, Publication No. 04-E007-2, Rockville
World Health Organisation: Global status report on noncommunicable diseases 2010. Description of the global burden of NCDs, their risk factors and determinants. Global status report on noncommunicable diseases 2010. 2011, Description of the global burden of NCDs, their risk factors and determinants, Geneva
Australian Institute of Health and Welfare: The Burden of Disease and Injury in Australia. Book The Burden of Disease and Injury in Australia. 2000, AIHW, Canberra
Alder J, Mayhew L, Moody S, Morris R, Shah R: The chronic disease burden - An analysis of health risks and health care usage. 2005, Cass Business School, City University, London
Joint WHO/FAO Expert Consultation on Diet Nutrition and Prevention of Chronic Diseases: Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. 2002, Publisher: World Health Organisation, Geneva
Nutbeam D: Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000, 15: 259-267. 10.1093/heapro/15.3.259.
Australian Bureau of Statistics: Health Literacy Australia. 2006, Australian Bureau of Statistics, Canberra
Rudd RE: Health literacy skills of U.S. adults. Am J Health Behav. 2007, 31: S8-18. 10.5993/AJHB.31.s1.3.
Sarkar U, Fisher L, Schillinger D: Is self‒efficacy associated with diabetes self‒management across race/ethnicity and health literacy?. Diabetes Care. 2006, 29: 823-829. 10.2337/diacare.29.04.06.dc05-1615.
Miller DP, Brownlee C, McCoy T, Pignone M: The effect of health literacy on knowledge and receipt of colorectal cancer screening: a survey study. BMC Fam Pract. 2007, 8: 16-10.1186/1471-2296-8-16.
Scott T, Gazmararian JA, Williams MV, Baker D: Health Literacy and preventive health care use among Medicare enrollees in a managed care organization. Med Care. 2002, 40 (5): 395-404. 10.1097/00005650-200205000-00005.
Keller DL, Wright J, Pace HA: Impact of health literacy on health outcomes in ambulatory care patients: a systematic review. Ann Pharmacother. 2008, 42: 1272-1281. 10.1345/aph.1L093.
Nutbeam D: The evolving concept of health literacy. Soc Sci Med. 2008, 67: 2072-2078. 10.1016/j.socscimed.2008.09.050.
Clement S, Ibrahim S, Crichton N, Wolf M, Rowlands G: Complex interventions to improve the health of people with limited literacy: A systematic review. Patient Educ Couns. 2009, 75 (3): 340-351. 10.1016/j.pec.2009.01.008.
Pignone M, DeWalt DA, Sheridan S, Berkman N, Lohr KN: Interventions to improve health outcomes for patients with low literacy: A systematic review. J Gen Intern Med. 2005, 20: 185-192. 10.1111/j.1525-1497.2005.40208.x.
National Health Service Health Advisory Service: Together we stand: the Commissioning, Role and Management of Child and Adolescent Mental Health Services. Edited by: Williams R, Richardson G. 1995, Stationery Office, London UK
Prochaska James O, De Clement C: Theoretical therapy: toward a more integrative model of change. Psychotherapy: Theory, Research & Practice. 1982, 19: 276-288.
Effective Public Health Practice Project: Quality Assessment Tool For Quantitative Studies. A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Book Quality Assessment Tool for Quantitative Studies. A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. 2004, McMaster University, Hamilton, ON
Thomas BH, Ciliska D, Dobbins M, Micucci S: A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Worldviews Evid Based Nurs. 2004, 1: 176-184. 10.1111/j.1524-475X.2004.04006.x.
Adolfsson ET, Walker-Engstrom ML, Smide B, Wikblad K: Patient education in type 2 diabetes‒A randomized controlled 1‒year follow‒up study. Diabetes Res Clin Pract. 2007, 76: 341-350. 10.1016/j.diabres.2006.09.018.
Aldana SG, Greenlaw RL, Diehl HA, Salberg A, Merrill RM, Ohmine S, Thomas C: Effects of an intensive diet and physical activity modification program on the health risks of adults. J Am Diet Assoc. 2005, : 371-381.
Simmons D, Voyle JA, Fout F, Feot S, Leakehe L: Tale of two churches: Differential impact of a church‒ based diabetes control programme among Pacific Islands people in New Zealand. Diabet Med. 2004, 21: 122-128. 10.1111/j.1464-5491.2004.01020.x.
Swerissen H, Belfrage J, Weeks A, Jordan L, Walker C, Furler J, McAvoy B, Carter M, Peterson C: A randomised control trial of a self-management program for people with a chronic illness from Vietnamese, Chinese, Italian and Greek backgrounds. Patient Educ Couns. 2006, 64: 360-368. 10.1016/j.pec.2006.04.003.
Collins R, Lee RE, Albright CL, King AC: Ready to be Physically Active? The Effects of a Course Preparing Low-Income Multiethnic Women to be more Physically Active. Health Educ Behav. 2004, 31: 47-64. 10.1177/1090198103255529.
Toobert DJ, Glasgow RE, Strycker LA, Barrera M, Ritzwoller DP, Weidner G: Long-term effects of the Mediterranean lifestyle program: a randomized clinical trial for postmenopausal women with type 2 diabetes (Provisional abstract). Int J Behav Nutr Phys Act. 2007, 4: 1-10.1186/1479-5868-4-1.
Lorig KR, Ritter PL, Jacquez A: Outcomes of border health Spanish/English Chronic Disease Self- management Programs. Diabetes Educ. 2005, 31: 401-409. 10.1177/0145721705276574.
Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl HW, Blair SN: Reduction in cardiovascular disease risk factors: 6 month results from Project Active. Prev Med. 1997, 883-892.
Sadur CN, Moline N, Costa M, Michalik D, Mendlowitz D, Roller S, Watson R, Swain BE, Selby JV, Javorski WC: Diabetes management in a health maintenance organization. Efficacy of care management using cluster visits. Diabetes Care. 1999, 22: 2011-2017. 10.2337/diacare.22.12.2011.
Boylan MJ, Renier CM, Knuths JS, Haller IV: Preventing cardiovascular disease in women: an Intervention-control randomized study. Minn Med. 2003, 86: 52-56.
Miller CK, Edwards L, Kissling G, Sanville L: Evaluation of a theory-based nutrition intervention for older adults with diabetes mellitus. J Am Diet Assoc. 2002, 102: 1069-1081.
Smith C, Ryan A: Change for Life/Cambia tu vida: a health promotion program based on the stages of change model for African descendent and Latino adults in New Hampshire. Prev Chronic Dis. 2006, 3: 1-11. 10.1191/1479972306cd086ed.
Siero F, Broer J, Bemelmans WJ, Meyboom-de Jong BM: Impact of group nutrition education and surplus value of Prochaska-based stage-matched information on health-related cognitions and on Mediterranean nutrition behavior. Health Educ Res. 2000, 15: 635-647. 10.1093/her/15.5.635.
Campbell MK, DeVellis BM, Strecher VJ, Ammerman AS, DeVellis RF, Sandler RS: Improving dietary behavior: the effectiveness of tailored messages in primary care settings. Am J Public Health. 1994, 84: 783-787. 10.2105/AJPH.84.5.783.
de Vries H, Kremers SP, Smeets T, Brug J, Eijmael K: The effectiveness of tailored feedback and action plans in an intervention addressing multiple health behaviors. American journal of health promotion: AJHP. 2008, 22: 417-425. 10.4278/ajhp.22.6.417.
Marcus BH, Block BC, Pinto BM, Forsyth LH, Roberts MB, Traficante RM: Efficacy of an individualized, Motivationally-tailored physical activity intervention. Ann Behav Med. 1998, 20: 174-180. 10.1007/BF02884958.
Lennox AS, Osman LM, Reiter E, Robertson R, Friend J, McCann I, Skatun D, Donnan PT: Cost effectiveness of computer tailored and non-tailored smoking cessation letters in general practice: randomised controlled. BMJ. 2001, 322: 1396-10.1136/bmj.322.7299.1396.
Koffman DM, Bezzarre T, Mosca L, Redberg R, Schmid T, Wattigney WA: An evaluation of Choose to Move 1999: an American Heart Association physical activity program for women. Arch Intern Med. 2001, 161: 2193-2199. 10.1001/archinte.161.18.2193.
Prochaska JO, Velicer WF, Redding C, Rossi JS, Goldstein M, DePue J, Greene GW, Rossi SR, Sun X, Fava JL, et al: Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms. Prev Med. 2005, 41: 406-416. 10.1016/j.ypmed.2004.09.050.
Prochaska JO, Velicer WF, Rossi JS, Redding CA, Greene GW, Rossi SR, Sun X, Fava JL, Laforge R, Plummer BA: Multiple Risk Expert Systems Interventions: Impact of Simultaneous Stage-Matched Expert System Interventions for Smoking, High-Fat Diet, and Sun Exposure in a Population of Parents. Health Psychol. 2004, 23: 503-516.
Graham-Clarke P, Oldenburg B: The effectiveness of a general‒practice‒based physical activity intervention on patient physical activity status. Behav Chang. 1994, 11: 132-144.
Little P, Dorward M, Gralton S, Hammerton L, Pillinger J, White P, et al: A randomised controlled trial of three pragmatic approaches to initiate increased physical activity in sedentary patients with risk factors for cardiovascular disease. Br J Gen Pract. 2004, 54: 189-195.
Steptoe A, Rink E, Kerry S: Psychosocial predictors of changes in physical activity in overweight sedentary adults following counseling in primary care. Prev Med. 2000, 31: 183-194. 10.1006/pmed.2000.0688.
Ogden J, Hoppe R: The relative effectiveness of two styles of educational package to change practice nurses' management of obesity. Int J Obes. 1997, 21: 963-971. 10.1038/sj.ijo.0800503.
Butler C, Rollnick S, Cohen D, et al: Motivational consulting versus brief advice for smokers in general practice: a randomized trial. Br J Gen Pract. 1999, 49: 611-616.
Calfas K, Sallis J, Oldenburg B, et al: Mediators of change in physical activity following an intervention in primary care: PACE. Prev Med. 1997, 26: 297-304. 10.1006/pmed.1997.0141.
Van Sluijs EMF, Van Poppel MNM, Twisk JWR, Van Mechelen W: Physical activity measurements affected participants' behavior in a randomized controlled trial. J Clin Epidemiol. 2006, 59: 404-411. 10.1016/j.jclinepi.2005.08.016.
Efraimsson EÃ, Hillervik C, Ehrenberg A: Effects of COPD self-care management education at a nurse-led primary health care clinic. Scand J Caring Sci. 2008, 22: 178-185. 10.1111/j.1471-6712.2007.00510.x.
Winkleby MA, Howard-Pitney B, Albright CA, Bruce B, Kraemer HC, Fortmann SP: Predicting achievement of a low‒fat diet: a nutrition intervention for adults with low literacy skills. Prev Med. 1997, 26: 874-882. 10.1006/pmed.1997.0231.
Delichatsios H, Hunt M, Lobb R, et al: EatSmart: efficacy of a multifaceted preventive nutrition intervention in clinical practice. Prev Med. 2001, 33: 91-98.
Hoffman AM, Redding CA, Goldberg D, Añel D, Prochaska JO, Meyer PM, Pandey D: Computer expert systems for African-American smokers in physicians offices: A feasibility study. Prev Med. 2006, 43: 204-211. 10.1016/j.ypmed.2006.03.025.
Ridgeway NA, Harvill DR, Harvill LM, Falin TM, Forester GM, Gose OD: Improved control of type 2 diabetes mellitus: A practical education/behavior modification program in a primary care clinic. South Med J. 1999, 92: 667-672. 10.1097/00007611-199907000-00004.
Kloek GC, van Lenthe FJ, van Nierop PWM, Koelen MA, Mackenbach JP: Impact evaluation of a Dutch community intervention to improve health-related behaviour in deprived neighbourhoods. Health Place. 2006, 12: 665-677. 10.1016/j.healthplace.2005.09.002.
Naylor P, Simmonds G, Riddoch C, et al: Comparison of stage-matched and unmatched interventions to promote exercise behaviour in the primary care setting. Health Educ Res. 1999, 14: 653-666. 10.1093/her/14.5.653.
Yajima S, Takano T, Nakamura K, Watanabe M: Effectiveness of a community leaders' programme to promote healthy lifestyles in Tokyo, Japan. Health Promot Int. 2001, 16: 235-243. 10.1093/heapro/16.3.235.
Wolf RL, Lepore SJ, Vandergrift JL, Basch CE, Yaroch AL: Tailored telephone education to promote awareness and adoption of fruit and vegetable recommendations among urban and mostly immigrant black men: A randomized controlled trial. Prev Med. 2009, 48: 32-38. 10.1016/j.ypmed.2008.10.015.
Brassington GS, Atienza AA, Perczek RE, DiLorenzo TM, King AC: Intervention-related cognitive versus social mediators of exercise adherence in the elderly. Am J Prev Med. 2002, 23: 80-86. 10.1016/S0749-3797(02)00477-4.
Block G, Wakimoto P, Mandel R, Metz D, Fujii ML, Feldman N, Sutherland B: A Randomized Trial of the Little by Little CD-ROM: Demonstrated Effectiveness in Increasing Fruit and Vegetable Intake in a Low-income Population. Prev Chronic Dis. 2004, 1 (3): 1-12.
Lancaster T, Dobbie W, Vos K, et al: Randomized trial of nurse-assisted strategies for smoking cessation in primary care. Br J Gen Pract. 1999, 49: 191-194.
Agurs-Collins T, Kumanyika S, Ten Have T, Adams-Campbell L: A randomised controlled trial of weight reduction and exercise for diabetes management in older African-American subjects. Diabetes Care. 1997, 20 (10): 1503-1511. 10.2337/diacare.20.10.1503.
Oenema A, Brug J, Dijkstra A, de Weerdt I, de Vries H: Efficacy and use of an internet‒delivered computer-tailored lifestyle intervention, targeting saturated fat intake, physical activity and smoking cessation: a randomized controlled trial. Ann Behav Med. 2008, 35: 125-135. 10.1007/s12160-008-9023-1.
McCormack L, Bann C, Squiers L, Berkman ND, Squire C, Schillinger D, Ohene-Frempong J, Hibbard J: Measuring Health Literacy: A Pilot Study of a New Skills-Based Instrument. J Health Commun. 2010, 15: 51-71. 10.1080/10810730.2010.499987.
Fiore MC JD, Baker TB: Smoking cessation: Principles and practice based upon the AHCPR Guideline, 19961. AnnBehavMed. 1997, 19: 213-219.
Michie S, Abraham C: Interventions to change health behaviours: evidence-based or evidence-inspired?. Psychol Health. 2004, 19: 29-49. 10.1080/0887044031000141199.
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2296/13/49/prepub