Effectiveness of health literacy interventions using digital communications in the European Union: a systematic...

Limited health literacy competencies are linked to adverse health outcomes and increased utilization of healthcare resources. Growing awareness of the importance of health literacy has spurred a number or recent studies exploring interventions that leverage digital communication tools across Europe. These tools-including web-based health information resources, digital games, and mobile health applications-have gained widespread popularity due to their potential to reach diverse populations at scale. The primary objective of this systematic review is to assess recent empirical evidence on the effectiveness of health literacy interventions that use digital communication tools within the European Union.

We conducted a systematic review of the literature on health literacy interventions published between 2018 and 2024 and indexed in PubMed. To be eligible, studies had to focus on health literacy interventions implemented in European Union countries, utilize a controlled study design, and report measurable outcomes. We screened 3,911 records based on abstracts or full texts, resulting in the inclusion of 26 studies that employed digital communication tools to enhance health literacy.

The interventions showed varying effectiveness in improving the health literacy levels of the target population. Mobile apps and patient decision aids demonstrated some potential, whereas digital learning tools and multimedia interventions were largely ineffective. Overall, interventions using digital communication tools showed potential for improving knowledge, at least in the short term. Mobile apps proved effective in improving health status, with sustained effects at follow-ups. Digital learning tools also showed promise in enhancing health status for patients. Regarding self-efficacy, mobile apps were more efficient than other tools, although the evidence was somewhat mixed. Multi-component interventions were generally not more effective than single-component interventions in improving patient outcomes, despite the greater effort involved. Although the evidence was limited, it suggested that individuals with lower socioeconomic status benefited equally from interventions using digital communication tools in the European Union.

Interventions leveraging digital communication are unlikely to be sufficient on their own to substantially improve baseline health literacy. However, they can effectively improve patient knowledge and, in some cases, health outcomes, and should therefore be utilized for these purposes.