Functional health literacy and healthy eating: Understanding the brazilian food guide recommendations

The low health literacy in Latin America and the Caribbean: a systematic review and meta-analysis

BACKGROUND

Health literacy (HL) impacts people's health and well-being. In Latin America and the Caribbean (LAC), there are no general estimates of the prevalence of low HL. This study aimed to estimate the prevalence of low HL among citizens of LAC and identify the tools used to measure it.

METHODS

We included observational studies quantifying the prevalence of low HL in people living in LAC. We searched PubMed, CINAHL, EMBASE, ERIC, LILACS, PsycINFO, Redalyc, SciELO, Web of Science, PQDT, and the reference lists of the included studies in June 2023. Two reviewers independently conducted the selection, extraction, and risk of bias assessment using the JBI Critical Appraisal Tools. Meta-analysis of proportions using random effects models was used to summarize the prevalence of low HL estimated. This prevalence was measured in each study using different classification methods: word recognition items, reading and numeracy comprehension items, and self-reported comprehension items.

RESULTS

Eighty four studies involving 23,914 participants from 15 countries were included. We identified 23 tools to assess HL, and most of the studies were carried out in health services. The pooled prevalence of low HL were 44.02% (95%CI: 36.12-52.24) for reading and numeracy comprehension items, 50.62% (95%CI: 41.82-59.39) for word recognition items, and 41.73% (95%CI: 31.76-52.43) for self-reported comprehension items.

CONCLUSION

Despite the variability in the prevalence of low HL and a diversity of tools, the average of low HL is of concern. Almost half of the participants in the included studies have low HL. Most of the studies targeted users of healthcare services. Further research investigating the prevalence of low HL in the general population and actions focused on health education, communication, and information are necessary.

TRIAL REGISTRATION

PROSPERO (CRD42021250286).

Food-Based Dietary Guidelines for Infants in Latin America and the Caribbean: A Systematic Review

Food-based dietary guidelines (FBDGs) are tools for promoting healthy eating habits. For the population of children under two years old in Latin America and the Caribbean (LAC), there is a lack of reviews analyzing the quality of these guidelines. The objective of this systematic review is to evaluate publicly available FBDGs for the population under two years old in LAC until mid-2023. Guidelines aimed at caregivers of children were included, sourced from government websites in LAC countries and the Food and Agriculture Organization (FAO) portal. Documents targeted at healthcare professionals were excluded. For qualitative analysis, the Agree II guidelines assessment tool and the FAO guide principles for developing healthy and sustainable diets were used. The results showed that more recently released and revised FBDGs with a greater number of pages obtained better scores in both assessments. Additionally, out of the 32 LAC countries, only 13 had these FBDGs available on websites for public access. As a limitation, this study faced challenges in standardizing the searches on government websites. The authors emphasize the need to develop FBDGs for the population under two years old that align with current health and sustainability needs and promote health education.

Health literacy of people with spinal cord injury: a systematic review

STUDY DESIGN

Systematic review.

OBJECTIVE

To systematically review the evidence on health literacy (HL) of people diagnosed with spinal cord injury (SCI).

METHODS

PubMed, Cochrane Library, Web of Science and Embase databases were used to identify studies published from 1974 to 2021. Two reviewers independently carried out the study selection process and assessed the methodological quality of the studies. The risk of bias in the studies was classified according to the Joanna Briggs Institute (JBI).

RESULTS

In total, 1398 studies were identified from the initial search, and 11 were selected for reading thoroughly. After screening, five studies were included. All had a cross-sectional design, and most scientific production was from the United States. In the studies, people with SCI received assistance in rehabilitation services. The results were heterogeneous compared to the HL: reasonable HL; suitable HL; Inadequate HL. Better HL was identified in individuals from the white population compared to the black population with SCI.

CONCLUSION

Studies on HL in the SCI population are limited. Guidance and personalized education provided in rehabilitation programs seem to have an influence on HL levels in this population. More research is needed to broaden the understanding of HL in the rehabilitation process of people diagnosed with SCI.

Scoping health literacy in Latin America

Studies evaluating the influence of health literacy on patient behavior and outcomes suggest a positive relationship between health literacy and health knowledge, health behaviors, and health status. In Latin American countries, studies assessing health literacy are few, regional, and demonstrate considerable variation, with reported rates of adequate health literacy ranging from 5.0% to 73.3%. In this paper, we examine and explore the state of health literacy and efforts to promote it in Latin America. Key challenges to those efforts include socioeconomic inequality, social/geographic isolation, and cultural-, language-, and policy-related barriers, many of which disproportionately affect indigenous populations and others living in rural areas. Greater use of infographics, videos, and mobile apps may enhance health literacy and patient empowerment, especially when language barriers exist. This paper provides strategies and tools for tailored programming, examples of successful health literacy interventions, and policy recommendations to improve health literacy in Latin America, intending to spur additional discussion and action. Centrally organized collaboration across multiple sectors of society, with community involvement, will enhance health literacy and improve health and well-being across Latin America.

LETRAMENTO EM SAÚDE E FATORES ASSOCIADOS EM ADULTOS USUÁRIOS DA ATENÇÃO PRIMÁRIA

Resumo O objetivo da pesquisa foi investigar o letramento em saúde e associação com fatores sociodemográficos, autopercepção da saúde e qualidade de vida em adultos. Tratou-se de estudo transversal com adultos entre 20 e 59 anos, usuários da atenção primária à saúde, realizado em unidades básicas de saúde, de fevereiro a maio de 2015 – amostra probabilística. O letramento em saúde foi avaliado pelo Short Assessment of Health Literacy for Portuguese-Speaking Adults. Realizou-se análise estatística descritiva, análise bivariada (p ≤ 0,20) e regressão logística múltipla (p ≤ 0,05). O letramento em saúde inadequado foi frequente e inicialmente associado a sexo, escolaridade, última série cursada com aprovação, estudo formal mínimo, Critério de Classificação Econômica Brasil, plano de saúde, arranjo familiar, importância atribuída à saúde, nota atribuída à própria saúde, frequência de comparecimento à unidade básica de saúde e aos domínios relações sociais e ambiental do teste World Health Organization Quality of Life. No modelo final da regressão logística, somente a escolaridade permaneceu associada ao letramento em saúde, e indivíduos com menor escolaridade tiveram mais chance de ter letramento em saúde inadequado. Os achados sugerem a necessidade do desenvolvimento de estratégias de educação em saúde para os adultos usuários da atenção primária.