Related Experiment Video
Updated: May 29, 2026

Qualitative and Quantitative Validation of Tools with Rating Scales Aimed at Assessing the Quality of University Service-Learning
Published on: August 29, 2025
Understanding the internal and external validity of health literacy interventions: a systematic literature review
Kacie Allen1, Jamie Zoellner, Monica Motley
1Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, Roanoke, Virginia 24016, USA. kaciea1@vt.edu
Abstract:
We conducted a systematic literature review, using the RE-AIM framework, with the goal of determining what information is available to inform research to practice translation of health promotion interventions developed to address health literacy. Thirty-one articles reflecting 25 trials published between 2000 and 2010 met inclusion criteria. Two researchers coded each article, using a validated RE-AIM (reach, effectiveness/efficacy, adoption, implementation, maintenance) data extraction tool, and group meetings were used to gain consensus on discrepancies. Across all studies (14 randomized controlled trials, 11 quasi-experimental; 24 clinic-based, 1 community-based), the mean level of reporting RE-AIM indicators varied by dimension (reach = 69%; efficacy/ effectiveness = 58%; adoption = 36%; implementation = 35%; maintenance = 11%). Among participants enrolled in the 25 interventions, approximately 38% were identified as low health literate. Only eight of the studies examined health literacy status as a moderator of intervention effectiveness. This review suggests that the current research on health promotion for participants with low health literacy provides insufficient information to conclude whether interventions for health literacy can attract the target population, achieve an effect that is sustainable, or be generalized outside of clinical settings. Recommendations for enhancing the design and reporting of these trials are provided.
Related Concept Videos
Health Literacy
Models of Health Promotion and Illness Prevention II
The agent-host-environment model states that disease results from...
Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
Models of Health Promotion and Illness Prevention I
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
Data Validation
Nursing assessment guides are generally based on holistic models rather than medical...
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...