Health Literacy in Fall-Prevention Strategy: A Scoping Review

Although the significance of health literacy (HL) in fall-prevention strategies is growing, limited knowledge is available regarding the relationship, impact, and role of HL in falls. This scoping review aimed to explore and synthesize the current evidence regarding the role of HL in enhancing fall prevention in hospital and community settings.

We adhered to the Joanna Briggs Institute manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews. PubMed, CINAHL, EMBASE, and the Cochrane Library were searched until November 2023 using Medical Subject Headings and text words. Studies related to HL and falls, regardless of study design, were considered eligible.

We screened 99,249 records, of which 27 were included: 12 interventional studies, seven observational studies, four qualitative studies, and four mixed-methods studies. Two-thirds of the studies were conducted in community-based settings. Four observational studies reported that HL was associated with fall-related outcome including fall incidence. Although intervention studies did not encompass all elements of HL based on the Health Literacy Framework, eight out of 12 intervention studies reported the effect of HL-embedded fall-prevention interventions, and HL was effective in fall-related outcomes including fall incidence in six studies. Three of 14 studies reported the measurement properties of fall-related HL. While HL can be increased through tailored information, verbal debriefing, interactive communication, and culturally adapted interventions, low HL impedes the understanding of education, engaging interventions, and using technological devices in implementing fall-prevention interventions in qualitative and mixed-methods studies.

This scoping review suggests that nurses need to recognize and assess patients' HL as a potential risk factor for falls and implement fall-prevention interventions based on the HL level of participants. Further research is required to develop culturally adapted and fall-relevant HL measures applicable to various vulnerable populations and settings.