Effective interventions to improve the health literacy of cancer patients

Health literacy (HL) refers to the cognitive and social abilities that are determinants in the motivation and capacity of the individual to access, understand and use information for the care of one's own health. In oncology, increased survival, navigation of the healthcare system, the many different forms of treatment and the management of adverse effects/outcomes make HL a critical factor in patient care. The objective of this study is to identify the structure, content and effectiveness of interventions to improve HL in cancer patients.

A literature review was performed using the '(health literacy OR Cancer Literacy) AND Cancer AND Intervention' strategy on seven multidisciplinary databases. Studies that intervened in subjects diagnosed with cancer and treating HL explicitly as a variable to be measured were included.

One thousand two hundred and thirty-six abstracts were retrieved. Eight studies met the inclusion criteria. Research focused on patients diagnosed with breast cancer or prostate cancer. Interventions used multimedia resources and face-to-face interactions. No study defined HL. HL was usually a secondary outcome. There is high variability in the design of studies and interventions and in the instruments used to measure HL. The effectiveness of the interventions varied between studies, with improvements that were diminished over time or insufficient in participants with initial low literacy.

The evidence to date in interventions oriented to study HL in patients with cancer is focused on other constructs, leaving HL as a phenomenon difficult to define both conceptually and clinically. Variability in designs and measurements makes comparison between interventions difficult. Defining and operationalizing HL is critical to design and measure effective interventions, which must be adapted to patients' needs.