Health literacy evaluation in Latin America and the Caribbean: a scoping review

Abstract

Background: Health literacy (Hl) is crucial for individuals’ interactions with healthsystems and their engagement with health-related information. it is influenced bycultural and linguistic diversity, socioeconomic factors, and the structure of healthsystems. latin America and the caribbean, marked by significant inequities, provide aunique context for investigating Hl. Understanding the methods to evaluate Hl canenhance the practices of health professionals, guide policymaking, and improveeducational initiatives tailored to the specific needs of the region.Aim: this study aimed to map the methodological approaches used to evaluate Hlacross populations in latin America and the caribbean.Methods: this review followed the JBi Manual for Scoping Reviews. Databases such asMeDliNe, ciNAHl, ScOPUS, web of Science, eMBASe, ScielO, lilAcS, BDeNF, iBecS, andGoogle Scholar were searched in July 2023. it included primary research that examinedHl evaluation using both quantitative and qualitative approaches. the extracted datafocused on study characteristics, research design procedures, and the areas and levelsof Hl assessed.Results: we analyzed a total of 228 studies published between 2009 and 2022, with70% published since 2019. A significant portion of the research was conducted in Brazil,Mexico, chile, and Peru, utilizing a quantitative approach (91%), mainly via cross-sectionaldesigns. the remaining studies employed qualitative (5%) or mixed-methods (4%)approaches. Research design procedures included the use of tools (68.2%), structuredquestionnaires (20.6%), and semi-structured questionnaires (including focus groups andindividual interviews) (11.2%). Most studies targeted patients with chronic diseases inclinical settings, while migrants and indigenous populations were comparativelyunderstudied. the majority of studies addressed generic, oral, and nutritional Hl,primarily using tools such as NvS, S-tOFHlA, and SAHlPA. Despite the variety of toolsused, most focused on functional aspects of Hl, with limited attention to itsmultidimensional and evolving nature.Discussion: to bridge Hl gaps, countries in the region must develop culturally andlinguistically appropriate tools and focus on under-researched groups, includingindigenous peoples and migrants.PLAIN LANGUAGE SUMMARYHealth literacy (Hl) helps people understand and use health information to make goodchoices in health. in latin America and the caribbean, many people face challenges likepoverty and limited access to healthcare. this review looked at 228 studies from 2009to 2022 to see how Hl has been evaluated in the region. Most studies focused onpeople with chronic illnesses and basic health skills. Few included underserved groupslike indigenous peoples or migrants. More research, better tools, and stronger effortsare needed to make health systems easier for everyone to understand and use.