Health literacy and child health outcomes: a systematic review of the literature.
Health literacy and child health outcomes: a systematic review of the literature.
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DOI：
10.1542/peds.2009-1162b
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发表时间：
2009-11-01
期刊：
影响因子：
8
通讯作者：
Hink, Ashley
中科院分区：
文献类型：
--
作者：
DeWalt, Darren A;Hink, Ashley
目的：回顾父母和儿童识字率与儿童健康结果之间的关系，以及旨在改善识字技能低的儿童或父母的儿童健康结果的干预措施。方法：我们检索了 Medline 和护理和联合健康文献累积指数 (CINAHL)，查找 1980 年至 2008 年发表的文章，纳入了报告原始数据、测量识字率和 > 或 = 1 健康结果的研究，并评估了识字率与健康之间的关系结果。健康结果包括健康知识、健康行为、医疗保健资源的使用、疾病状态的中间标志和发病率测量。两名摘要者审查了每项研究以纳入其中。纳入的研究被提取到证据表中，并使用 11 项质量量表进行评估。 结果：我们回顾了 2003 年以来发表的 4182 篇新标题和摘要。保留了 58 篇文章进行全面审查，其中 13 篇符合纳入标准。 1980年至2003年的系统评价中有11篇文章符合纳入标准，总共24篇文章。识字率低的儿童通常健康行为较差。与识字率较高的父母相比，识字率较低的父母健康知识较少，行为也不利于孩子的健康。父母识字率低的孩子往往健康状况较差，但我们发现识字率与医疗保健服务使用之间的关系结果好坏参半。干预措施发现，改进书面材料可以增加健康知识，将良好的书面材料与简短的咨询相结合可以改善包括依从性在内的行为。研究的平均质量为一般至良好。结论：儿童和家长的识字率似乎与重要的健康结果相关。未来的研究可以帮助我们了解在什么情况下这种关系是因果关系，识字率和健康结果如何在非因果路径中相关，父母和儿童识字率的相对重要性，以及哪些干预措施可以有效减少与健康素养相关的差异。
OBJECTIVES: To review the relationship between parent and child literacy and child health outcomes and interventions designed to improve child health outcomes for children or parents with low literacy skills.METHODS: We searched Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for articles published from 1980 through 2008 and included studies that reported original data, measured literacy and >or=1 health outcome, and assessed the relationship between literacy and health outcomes. Health outcomes included health knowledge, health behaviors, use of health care resources, intermediate markers of disease status, and measures of morbidity. Two abstractors reviewed each study for inclusion. Included studies were abstracted into evidence tables and were assessed by using an 11-item quality scale.RESULTS: We reviewed 4182 new titles and abstracts published since 2003. Fifty-eight articles were retained for full review, and 13 met the inclusion criteria. Eleven articles from the systematic review from 1980 to 2003 met the inclusion criteria, giving us a total of 24 articles. Children with low literacy generally had worse health behaviors. Parents with low literacy had less health knowledge and had behaviors that were less advantageous for their children's health compared with parents with higher literacy. Children whose parents had low literacy often had worse health outcomes, but we found mixed results for the relationship of literacy to the use of health care services. Interventions found that improving written materials can increase health knowledge, and combining good written materials with brief counseling can improve behaviors including adherence. The average quality of the studies was fair to good.CONCLUSIONS: Child and parent literacy seems associated with important health outcomes. Future research can help us understand under what circumstances this relationship is causal, how literacy and health outcomes are related in noncausal pathways, the relative importance of parent and child literacy, and what interventions effectively reduce health literacy-related disparities.