Approaches to assessment of community level health literacy: a scoping review

Addressing health literacy at the community level can provide the potential for improving health knowledge, skills, and behaviours that can ultimately lead to better health outcomes. While many tools exist for measuring individual and disease-specific health literacy, community and critical health literacy have received less attention. The review focuses on geographic communities and includes the concepts of 'health literacy', 'critical health literacy', and 'assessment'. Key information sources for the review were Scopus, EMBASE, MEDLINE, CINAHL, ERIC, and PsycINFO, along with Google Scholar for grey literature. Hand searches of reference lists from included studies were also conducted. The search was limited to articles published between 1 January 2010, and 1 June 2023, with no restrictions on data collection methods or study design. Data were charted following guidelines from the Joanna Briggs Institute and PRISMA ScR. Initially, 14 216 citations were retrieved, with 8612 remaining after removing duplicates. Double-blind screening of titles and abstracts resulted in 33 articles, which underwent double-blind full-text screening. Three articles were included, and a hand search identified one more, totalling four articles. The small number of eligible articles and the heterogeneity of content reflect the nascent stage of development of community level health literacy and its assessment. The review findings highlight the need to develop tools to assess community level health literacy to support interventions in empowering communities in maintaining and promoting their own health.