Understanding the internal and external validity of health literacy interventions

A systematic literature review using the RE-AIM framework

Kacie Allen, Jamie Zoellner, Monica Motley, Paul A Estabrooks

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

We conducted a systematic literature review, using the RE-AIM framework, with the goal of determining what information is available to inform research to practice translation of health promotion interventions developed to address health literacy. Thirty-one articles reflecting 25 trials published between 2000 and 2010 met inclusion criteria. Two researchers coded each article, using a validated RE-AIM (reach, effectiveness/efficacy, adoption, implementation, maintenance) data extraction tool, and group meetings were used to gain consensus on discrepancies. Across all studies (14 randomized controlled trials, 11 quasi-experimental; 24 clinic-based, 1 community-based), the mean level of reporting RE-AIM indicators varied by dimension (reach=69%; efficacy/ effectiveness=58%; adoption=36%; implementation=35%; maintenance=11%). Among participants enrolled in the 25 interventions, approximately 38% were identified as low health literate. Only eight of the studies examined health literacy status as a moderator of intervention effectiveness. This review suggests that the current research on health promotion for participants with low health literacy provides insufficient information to conclude whether interventions for health literacy can attract the target population, achieve an effect that is sustainable, or be generalized outside of clinical settings. Recommendations for enhancing the design and reporting of these trials are provided.

Original languageEnglish (US)
Pages (from-to)55-72
Number of pages18
JournalJournal of Health Communication
Volume16
Issue numberSUPPL. 3
DOIs
StatePublished - Oct 11 2011

Fingerprint

Health Literacy
literacy
Maintenance
Health
Health Promotion
health
health promotion
Group Processes
Health Services Needs and Demand
Research
Health Status
Consensus
moderator
available information
Randomized Controlled Trials
Research Personnel
Moderators
inclusion
literature
community

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Library and Information Sciences
  • Communication

Cite this

Understanding the internal and external validity of health literacy interventions : A systematic literature review using the RE-AIM framework. / Allen, Kacie; Zoellner, Jamie; Motley, Monica; Estabrooks, Paul A.

In: Journal of Health Communication, Vol. 16, No. SUPPL. 3, 11.10.2011, p. 55-72.

Research output: Contribution to journalArticle

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