Table 1.
Health Literacy Interventions in Low- and Middle-Income Countries
| Study | Design | Setting or Region | Purpose/Area of Study | Health Literacy Intervention | Target Population | Outcome |
|---|---|---|---|---|---|---|
| Ahmad et al. (2018) | Quantitative (pre-test and post-test) | Karachi, Pakistan | The study assessed the use of bilingual pictorial (Urdu and English) storybooks to improve road-traffic incidents (RTIs) prevention knowledge among school children | Interactive discussion | Children in grades 4 and 5 | Discussions using bilingual pictorial storybooks helped primary school children in Pakistan grasp knowledge of RTIs prevention |
| Ayub et al. (2015) | Interventional exploratory study using a mixed methods approach | Public Girls' Degree College (Pakistan) | The objectives demonstrated the effectiveness of service-learning in fostering civic responsibility and communication skills in college students and to increase health literacy regarding iron deficiency anemia (IDA) among students and women in the community | Small interactive group sessions | College students | Students showed significant improvement in all three constructs of civic responsibility and in perceptions of their communication skills |
| Basir et al. (2017) | Quantitative, experimental, and control group study | Ahvaz, Iran | The study evaluated an intervention for preventing early childhood caries (ECC) in a pediatric population | Well baby care, educational interventions, and lecture and group discussion | Women with children age 12 to 36 months without dental caries | Interventions had positive effects on the perceived threat, health literacy, and health behaviors; and the intervention could reduce the incidence of ECC |
| Bella-Awusah et al. (2014) | Quantitative pre-intervention, immediate post-intervention, and 6-month post-intervention questionnaire | Ibadan Southwest, Nigeria | The study aimed to assess the effect of a school-based mental health awareness program on increasing mental health literacy and reducing negative views about people with mental illness | A 3-hour mental health awareness session | Secondary school students | Brief training workshops potentially produced small but positive changes in the mental health knowledge of young Nigerians |
| Braich et al. (2011 | Quantitative and randomized control trial (RCT) | India | The study examined the effectiveness of pictograms in educating patients with low health literacy to improve adherence to postoperative cataract regimens | Three groups educated differently regarding medication use and frequency of dose | Patients from across India | Patients taking pictograms home proved to be the most effective way to educate them, and it increased adherence to regimens by 28 days or more |
| Hanass-Hancock (2014) | Quantitative survey | Rural community in South Africa | The study investigated the association between contextual factors, such as caregivers, peers, and exposure to the literacy classes regarding HIV knowledge, attitudes, and practice in school-age children | Literacy and drama classes | Male and female adolescents | Contextual factors may influence sexual behavior and self-efficacy as well as attitudes toward condom use |
| Haricharan et al. (2017) | Quantitative questionnaire | South Africa | The study aimed to assess whether a short message service (SMS)-based health promotion campaign could improve people who are hearing impaired knowledge of hypertension and healthy living | SMS-based information campaign | People who are hearing impaired | Statistically significant improvement in overall knowledge about hypertension and healthy living was attained |
| Hikita et al. (2018) | Population-based cross-sectional study | Bulgan Province, Mongolia | The study investigated the use of a Maternal and Child Health (MCH) handbook, and related factors | MCH handbook | Women with children born between January and December 2010 | Mothers with middle or high educational attainment were more likely to have read the handbook than those with low educational attainment |
| Hobday et al. (2015) | A descriptive, mixed-methods design, questionnaires, and interviews | Four primary schools in Aileu District, Timor-Leste | The study assessed whether there was an improvement in the knowledge, attitudes, and practices of students after the Healthy Eyes in Schools Project intervention | Training and resources to implement nine lessons about eye health | Students in grades 5 and 6 | Students attained an improvement in eye health knowledge |
| Kharboush et al. (2011) | A pre-/post-test interventional study | Egypt | The study aimed to determine the effectiveness of a health education program on raising the knowledge related to breast cancer (BC), its risk factors, and some related preventive practices among women | Health education sessions | Women age 30–65 years | Participants increased their mean knowledge score regarding BC and the mean opinion score regarding some BC risk factors |
| Khudanov et al. (2018) | Quantitative RCT | Uzbekistan | The study aimed to determine whether an oral health education program using an imaging device based on quantitative light-induced fluorescence (QLF) technology could improve the oral hygiene status and oral health literacy of adolescents | Education and training on dental plaque removal using the QLF device | Adolescents age 14–16 years | Statistically significant improvements in the experimental group compared to the control group in the plaque index was attained |
| León et al. (2014) | Quasi-experiment | India | The study aimed to determine whether literacy moderated the effects on women's decision-making power of the family planning intervention and whether literacy and women's decision-making power together moderated the effects of the intervention on met need for contraception | Family planning intervention, education via community theater performances | Married women ages 15–49 years | Women's normative beliefs concerning wives' power in decisions regarding money earned and visits to relatives and friends vis-à-vis their husbands' power were increased |
| Li et al. (2016) | Randomized, unblinded, controlled trial | Niger | The study aimed to investigate the malaria health literacy level of Chinese expatriates in Niger and to develop a health education program for the prevention and treatment of malaria among travelers who are not immune | Malaria health literacy | Chinese expatriates in Niger | Participants exhibited a greater change in knowledge, attitude, practice, skills, and overall health literacy |
| Loh et al. (2009) | Quantitative | Malaysia | This article described the knowledge of Malaysian women regarding BC and how participation in a self-management program can improve the situation | Self-management program | Women newly diagnosed with BC | Post-intervention showed significantly better knowledge within the experimental group |
| Lori et al. (2017) | Prospective cohort | District hospital in Kumasi, Ghana | The study examined whether exposure to group antenatal care increased women's health literacy by improving their ability to interpret and use health messages compared to women who received standard, individual antenatal care | Group antenatal care | Pregnant women | Women participating demonstrated improved health literacy by exhibiting a greater understanding of how to operationalize health education messages |
| Lori et al. (2015) | Prospective cohort | Ghana | The study examined the usefulness and feasibility of providing focused antenatal care in a group setting to improve patient-provider communication, patient engagement, and health literacy | Antenatal care modules | Pregnant women | Significant difference between women enrolled in group antenatal care versus individual antenatal care for preventing problems before delivery, understanding when to access care, birth preparedness and complication readiness, intent to use a modern method of family planning postpartum, greater understanding of the components of breast-feeding and lactational amenorrhea for birth spacing, and intent for postpartum follow-up was apparent |
| McGinn & Allen (2006) | Qualitative | Guinea | The study researched the Reproductive Health Literacy Project among Sierra Leonean and Liberian women in refugee camps | Literacy classes | Sierra Leonean and Liberian women | Participants had a high level of reproductive health knowledge after participation, and reported an increase in literacy skills |
| Mhlongo et al. (2018) | Quantitative (pre-intervention) and post-intervention | South African National Science Festival | The study determined the effects of a health education program on increasing knowledge about diabetes and encouraging preventive measures | A public health education exhibition | School children | Participants experienced a significant difference in their mean scores after the intervention |
| Mindlis et al. (2015) | Cross-sectional study | Rural Gujarat, India | The study compared social representations of depression in villages where educational programs have targeted mental illness and stigma versus control villages | Educational interventions | Male and female participants age 18–78 years | Higher levels of literacy regarding depression and lower levels of stigma, after adjusting for all other sociodemographic variables, were demonstrated |
| Nabunya et al. (2015) | Quantitative | Southern Uganda | This study evaluated the effect of a peer mentorship program provided in addition to other supportive services on HIV/AIDS knowledge, beliefs, and prevention attitudes | Peer mentorship program | School-going adolescents who were orphaned | Results indicate that when controlling for socioeconomic characteristics, adolescents who participated were more likely than nonparticipants to report increased scores on HIV/AIDS knowledge |
| Ngy et al. (2007) | Survey | Phnom Penh, Cambodia | The study aimed to examine the use of antenatal care with comprehensive health education qualified for the health of mothers and infants during perinatal and postpartum periods | Antenatal care with comprehensive health education | Pregnant women | Results show the solid utilities of qualified antenatal care for perinatal health |
| Noronha et al. (2013) | Quasi-experimental (pre-test and post-test) | Southern India | The study determined the effectiveness of a health information package in terms of empowering the pregnant women to modify their health care behavior and take appropriate action to combat anemia in pregnancy | Validated planned educational program with visual aids and iron supplementation | Pregnant women with anemia | Health education contributed significantly in modifying health-seeking behavior and perception about significance of anemia |
| Rajan & Nayak (2014) | One group pre-test post-test design which was a pre-experiment | Mangalore, Indian state of Karnataka and South India | The study determined the effectiveness of a self-instructional module on knowledge of postoperative self-care for mothers undergoing elective cesarean deliveries | Self-instructional module | Mothers who underwent elective cesarean delivery | Participants knowledge of post-operative self-care was improved |