Health Literacy in Traditional, Complementary and Integrative Medicine Users: A Systematic Review

Traditional, complementary and integrative medicine (TCIM) use is widespread, particularly among individuals with chronic health conditions who are drawn to TCIM's holistic approach. This approach frequently involves educating users on lifestyle factors that may detrimentally impact their health outcomes. Consequently, the TCIM workforce holds much potential to facilitate public health promotion and education. However, little is known about the current healths literacy (HL) of TCIM users - a gap requiring focus to optimize the role of TCIM in preventive health efforts. This review aims to determine the level of HL reported by TCIM users and identify relationships between HL and TCIM use. A systematic literature search for eligible studies was conducted using five scientific databases: EMBASE, MEDLINE, CINAHL, AMED, and Scopus. All databases were searched from their inception to January 2024. All relevant observational studies on the HL of TCIM users were included. From the 23 included studies, mean HL scores among most participants fell into the "borderline-sufficient" or "moderate-high" categories. These scores ssuggest HL may be associated with, or result from, frequent interactions with TCIM practitioners or services. Several sociodemographic characteristics shared a positive relationship with HL and TCIM use, including higher socioeconomic status. This review captures the breadth of HL scores reported by TCIM users and aims to elucidate relationships between HL and TCIM use. By enhancing our understanding of the health knowledge within this population, public health policies, educational programs, and future research can be more effectively targeted to user needs.