Table 2.
Results of methodological quality assessment of all included studies.
| ITEM (description)19 | Aharon, 201725 | Bennett, 200920 | Johri, 201526 | Lee, 201527 | Moran, 201721 | Pati, 201122 | Smith, 201523 | Veldwijk, 201524 | White, 200812 | % |
|---|---|---|---|---|---|---|---|---|---|---|
| 1. Are the objectives or hypotheses of the study stated? (Self-explanatory) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 100.0 |
| 2. Is the target population defined? (The group of persons toward whom inferences are directed. Sometimes the population from which a study group is drawn) | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 88.9 |
| 3. Is the sampling frame defined? (The list of units from which the study population will be drawn) | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 77.8 |
| 4. Is the study population defined? (The group selected for investigation) | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 88.9 |
| 5. Are the study settings (venues) and/or geographic locations stated? (Comment required about location of research. Could include name of center, town, or district) | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 88.9 |
| 6. Are the dates during which the study was conducted stated or implicit? (Self-explanatory) | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 77.8 |
| 7. Are the eligibility criteria stated? (The words “eligibility criteria” or equivalent are needed, unless the entire population is the study population) | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 88.9 |
| 8. Are the issues of ‘selection in’ to the study mentioned? (Any aspect of recruitment or setting that results in the selective choice of participants) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 11.1 |
| 9. Is the number of participants justified? (Justification of number of subjects needed to detect anticipated effects. Evidence that power calculations were considered and/or conducted.) | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | 33.3 |
| 10. Are numbers of participants meeting and not meeting the eligibility criteria stated? (Quantitative statement of numbers) | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 22.2 |
| 11. For those not eligible, are the reasons why stated? (Broad mention of the major reasons) | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 11.1 |
| 12. Is the number of people who did/did not consent to participate stated? (Quantitative statement of numbers) | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 0 | 22.2 |
| 13. Are the reasons people refused to consent stated? (Broad mention of the major reasons) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 14. Were consenters compared with non-consenters? (Quantitative comparison of the different groups) | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 11.1 |
| 15. Was the number of participants at the beginning of the study stated? (Total number of participants -after screening for eligibility and consent- included in the first stage of data collection) | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 77.8 |
| 16. Were methods of data collection stated? (Descriptions of tools) | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 88.9 |
| 17. Was the reliability (repeatability) of measurement methods mentioned? (Evidence of reproducibility of the tools used) | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 44.4 |
| 18. Was the validity (against a ‘gold standard’) of methods of measurement mentioned? (Evidence that the validity was examined against, or discussed in relation to, a gold standard) | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 44.4 |
| 19. Were any confounders mentioned? (Confounders were defined as a variable that can cause or prevent the outcome of interest, is not an intermediate variable, and is associated with the factors under investigation) | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 88.9 |
| 20. Was the number of participants at each stage/wave specified? (Quantitative statement of numbers at each follow-up point) | NA | NA | NA | NA | NA | 1 | NA | NA | NA | 100.0 |
| 21. Were reasons for lack of follow-up quantified?*(Broad mention and quantification of the major reasons) | NA | NA | NA | NA | NA | 0 | NA | NA | NA | 0 |
| 22. Was the number of missing data items at each wave mentioned?*(Differences in numbers of data points -indicating missing data items- explained) | NA | NA | NA | NA | NA | 1 | NA | NA | NA | 100.0 |
| 23. Were the types of analyses conducted stated? (Specific statistical methods mentioned by name) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 100.0 |
| 24. Were ‘longitudinal’ analysis methods stated?*(Longitudinal analyses were defined as those assessing change in outcome over two or more time points and that take into account the fact that the observations are likely to be correlated) | NA | NA | NA | NA | NA | 1 | NA | NA | NA | 100.0 |
| 25. Were absolute effect sizes reported? (Absolute effect was defined as the outcome of an exposure expressed, for example, as the difference between rates, proportions, or means, as opposed to the ratios of these measures) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 26. Were relative effect sizes reported? (Relative effects were defined as a ratio of rates, proportions, or other measures of an effect) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 100.0 |
| 27. Was lack of follow-up taken into account in the analyses?*(Specific mention of adjusting for, or stratifying by, loss to follow-up) | NA | NA | NA | NA | NA | 0 | NA | NA | NA | 0 |
| 28. Were confounders accounted for in the analyses? (Specific mention of adjusting for, or stratifying by, confounders) | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 88.9 |
| 29. Were missing data accounted for in the analyses? (Specific mention of adjusting for, or stratifying by, or imputation of missing data items) | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 22.2 |
| 30. Was the impact of biases assessed qualitatively? (Specific mention of bias affecting results, but magnitude not quantified) | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 88.9 |
| 31. Was the impact of biases estimated quantitatively? (Specific mention of numerical magnitude of bias) | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 55.6 |
| 32. Did authors relate the results back to a target population? (A study is generalizable if it can produce unbiased inferences regarding a target population -beyond the subjects in the study) | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 1 | 1 | 77.8 |
| 33. Was there any other discussion of generalizability? (Discussion of generalizability beyond the target population) | 1 | 0 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 77.8 |
| Not applicable items | 28 | 28 | 28 | 28 | 28 | 33 | 28 | 28 | 28 | |
| Total score, N (%) | 16 (57.1) | 19 (67.9) | 17 (60.7) | 15 (53.6) | 17 (60.7) | 24 (72.7) | 7 (25.0) | 19 (67.9) | 20 (71.4) |
*
not for cross-sectional.
The term ‘critical HL’ refers to cognitive skills that can be applied to critically analyse information and use it to exert greater control over life events and situations.
The term ‘evaluation skills’ refers to the ability to filter, interpret, and evaluate information.
The term ‘interactive HL’ refers to more advanced cognitive and literacy skills that, together with social skills, can be used to actively participate in everyday situations, extract information and derive meaning from different forms of communication, and apply this to changing circumstances.5