Improving health and scientific literacy in disadvantaged adults: a scoping review of interventions

BACKGROUND: People with low socioeconomic status face high health risks and poor health literacy. Tailored health education could help reduce these disparities. This scoping review sought to provide an up-to-date overview of approaches to craft and conduct interventions to improve health and scientific literacy in disadvantaged adults. METHODS: 7 databases were searched from 2012 to 2022. Data about research design, settings, target groups, topics, skills, theoretical foundations, materials, methodologies, outcomes, and evaluation tools were extracted from the selected articles. Quality assessment was done using the Crowe Critical Appraisal Tool. RESULTS: The review included 50 studies, most of which were quasi-experimental, involving participants with low income or limited education, ethnic minorities, or immigrants. Frequently theory-driven, these interventions were conducted in community settings and used various interactive methods like discussions and practical exercises. Functional and interactive health literacy dimensions were emphasised more than critical and scientific ones. Many programs highlighted cultural appropriateness and customization. Researchers often involved participants in program development or execution. Evaluations assessed knowledge, health literacy, behavioural and psychological gains using various quantitative and qualitative instruments. Critical appraisal of the studies revealed quality limitations. CONCLUSIONS: Participatory methods, interactivity and culturally appropriate materials are crucial for crafting relevant health education for disadvantaged groups. Greater emphasis should be placed on developing critical and scientific health literacy skills. KEY MESSAGES: • This study provides novel findings on the ways to design and evaluate health literacy interventions targeted at vulnerable groups. • Such guidance can be valuable for health education practitioners.