Health Literacy Interventions in cancer care: A review of systematic reviews

BACKGROUND: Health literacy (HL), refers to the cognitive and social qualities that influence an individual's motivation and capacity to acquire, comprehend, and apply information to improve their own health. Therefore, interventions targeting HL may allow a better understanding of the illness leading to better-adapted behaviors. Interventions targeting HL in an illness such as cancer may be essential due to the high disease burden, the availability of cancer screening programs, the complexity of multimodal therapy, and the emphasis on cancer clinical trials. This study will review systematic reviews that look into different HL interventions in oncology and hematology targeting patients, health care professionals, and/or organizational HL. The objective of this study is to highlight the already studied factors and their effectiveness, in addition to highlighting the missing factors in light of recent findings on different concepts within HL. METHODS: A literature search was performed using terms such as Cancer AND health literacy AND Interventions AND patients or medical staff, or medical organizations in five different multidisciplinary databases. Reviews that constituted studies that targeted interventions in the oncology population and explicitly mentioned HL as a factor or an outcome were included. RESULTS: A hundred and thirteen studies were retrieved. Seven studies fit the criteria and were therefore included. The ongoing study's preliminary results show no intervention studies targeting organizational HL. Most reviews included interventions at the patient level. The effectiveness of the interventions varied among studies. Most HL interventions targeted patient communication skills training. CONCLUSIONS: Most of the interventions to date target HL through patient education and communication making it difficult to apply HL in the entirety of its definition, clinically. KEY MESSAGES: • Interventions considered as Health Literacy interventions often target solely patient education. • A call for better use of the term Health Literacy is needed in order to address the different aspects of englobed by HL through its definition and its application.