. 2022 Feb 18;25(3):856–868. doi: 10.1111/hex.13450

Table 2.

Summary details of included systematic reviews and conceptual analyses

Author	Study type	Aims and/or research questions	Data sources and search terms	Analysis and synthesis	How was distributed health literacy included?
Gessler et al. (2019) ²³	Systematic review	To identify and synthesize qualitative studies that have addressed the interactional process facilitating empowerment and participation in shared decision‐making in adolescents and young adults and their families	Searched Embase, MEDLINE, PsycInfo and CINAHL. Search strategy combined the concept of health literacy with the involvement of family members. As such, health literacy was captured using a broad range of search terms, including shared decision‐making, patient participation patient involvement, health literacy, patient communication, empowerment and patient engagement. Family involvement in patient care was captured by search terms, including parent, triad, carer, caregiver, family, sibling and partner	Data were analysed using the Framework method. During the early data analysis, authors identified that a subset of themes aligned with the Supported Health Literacy Pathway Model, so a hybrid process of inductive and deductive coding was used to analyse data	In the results, a central theme was: ‘Distribution of health literacy skills among AYA‐family–clinician triads’, which included the following subthemes: 1. Shared health knowledge 2. Supported skills and practices 3. Supported action 4. Coproduced informed options 5. Supported decisions
Bröder et al. ²⁴ (2020)	Literature review	To discuss children's and young people's health literacy by elaborating and exploring childhood and youth as life phases with unique characteristics from multidisciplinary perspectives	Specific data sources and search terms not specified—‘We studied literature from childhood studies, educational and sociological research to identify and explore unique particularities of children and young people that are of relevance for health literacy research and practice’	Adapted the ‘D’ framework used by Rothman et al. ²⁹ (2009) : (1) Disease patterns and health perspectives, (2) demographic patterns: contextual factors and inequalities, (3) developmental change: socialization and life course perspective, (4) dependency: power structures and intergenerational relationships, and (5) democracy: active citizenship and participation	Distributed health literacy was included in the dimension: ‘Dependency: power structures and intergenerational relationships’ through the recognition that children's and young people's ‘agency can be regarded as being determined by the opportunities presented within the different social contexts, demographic and socioeconomic circumstances, as well as the distributed resources’
Bröder et al. (2020) ²⁵	Conceptual analysis	To analyse, examine and reflect upon prominent health literacy understandings in childhood and youth	Applied an iterative process to ‘search for and analyse relevant, multidisciplinary literature from childhood studies, educational science, and sociology’. Also ‘drew on the results of a systematic review of available conceptual understandings of health literacy for children and young people’	Analysed the identified body of literature to identify attributes and components of health literacy. The identified attributes and components were deconstructed and categorized by clarifying their characteristics, their assumptions, and their relation towards each other. Results were grouped and synthesized through an iterative process facilitated by reflective and analytical discussions within the research team	Results acknowledged that identified studies addressed the health literacy of persons close to the child, such as caregivers, mothers, parents and teachers, and noted that ‘researchers have proposed that child and adolescent health literacy should be regarded as the product of both individual health literacy skills and the skills or resources available in the proximal social context—namely, the adults, peers or institutions that young people trust. Among others, this is referred to as “collective” or “distributed” health literacy’. In proposing a target‐group‐centred health literacy definition for children and young people, authors note that the relatedness and contextual embeddedness of health literacy is placed at the core of this definition by recognizing individual and distributed resources within given structures. Health literacy is considered as being socially embedded and distributed on individual, family and social levels

Author

Study type

Aims and/or research questions

Data sources and search terms

Analysis and synthesis

How was distributed health literacy included?

Gessler et al. (2019) ²³

Systematic review

To identify and synthesize qualitative studies that have addressed the interactional process facilitating empowerment and participation in shared decision‐making in adolescents and young adults and their families

Searched Embase, MEDLINE, PsycInfo and CINAHL. Search strategy combined the concept of health literacy with the involvement of family members. As such, health literacy was captured using a broad range of search terms, including shared decision‐making, patient participation patient involvement, health literacy, patient communication, empowerment and patient engagement. Family involvement in patient care was captured by search terms, including parent, triad, carer, caregiver, family, sibling and partner

Data were analysed using the Framework method. During the early data analysis, authors identified that a subset of themes aligned with the Supported Health Literacy Pathway Model, so a hybrid process of inductive and deductive coding was used to analyse data

In the results, a central theme was: ‘Distribution of health literacy skills among AYA‐family–clinician triads’, which included the following subthemes:

1.
Shared health knowledge
2.
Supported skills and practices
3.
Supported action
4.
Coproduced informed options
5.
Supported decisions

Bröder et al. ²⁴ (2020)

Literature review

To discuss children's and young people's health literacy by elaborating and exploring childhood and youth as life phases with unique characteristics from multidisciplinary perspectives

Specific data sources and search terms not specified—‘We studied literature from childhood studies, educational and sociological research to identify and explore unique particularities of children and young people that are of relevance for health literacy research and practice’

Adapted the ‘D’ framework used by Rothman et al. ²⁹ (2009)

: (1) Disease patterns and health perspectives, (2) demographic patterns: contextual factors and inequalities, (3) developmental change: socialization and life course perspective, (4) dependency: power structures and intergenerational relationships, and (5) democracy: active citizenship and participation

Distributed health literacy was included in the dimension: ‘Dependency: power structures and intergenerational relationships’ through the recognition that children's and young people's ‘agency can be regarded as being determined by the opportunities presented within the different social contexts, demographic and socioeconomic circumstances, as well as the distributed resources’

Bröder et al. (2020) ²⁵

Conceptual analysis

To analyse, examine and reflect upon prominent health literacy understandings in childhood and youth

Applied an iterative process to ‘search for and analyse relevant, multidisciplinary literature from childhood studies, educational science, and sociology’. Also ‘drew on the results of a systematic review of available conceptual understandings of health literacy for children and young people’

Analysed the identified body of literature to identify attributes and components of health literacy. The identified attributes and components were deconstructed and categorized by clarifying their characteristics, their assumptions, and their relation towards each other. Results were grouped and synthesized through an iterative process facilitated by reflective and analytical discussions within the research team

Results acknowledged that identified studies addressed the health literacy of persons close to the child, such as caregivers, mothers, parents and teachers, and noted that ‘researchers have proposed that child and adolescent health literacy should be regarded as the product of both individual health literacy skills and the skills or resources available in the proximal social context—namely, the adults, peers or institutions that young people trust. Among others, this is referred to as “collective” or “distributed” health literacy’. In proposing a target‐group‐centred health literacy definition for children and young people, authors note that the relatedness and contextual embeddedness of health literacy is placed at the core of this definition by recognizing individual and distributed resources within given structures. Health literacy is considered as being socially embedded and distributed on individual, family and social levels