Scoping review of health literacy interventions with migrant communities: current knowledge, existing gaps and future directions

Abstract

ABSTRACT - Background: Health Literacy (HL) is a moderator between the social determinants of health and health outcomes. Vulnerable populations, such as migrants with lower socioeconomic status, tend to show a higher proportion of limited HL which can contribute to health disparities. The increase in migration trends in Europe requires healthcare systems to become more accessible and highlights the need to develop tailored HL interventions to improve migrants’ health. There is a growing body of primary research conducted on migrants, however, little is known about HL interventions for migrants. Objective: This scoping review aims to: 1) summarize current knowledge about HL intervention for migrants, 2) characterize the target population of these HL interventions, 3) identify the strengths and gaps of the interventions focusing on context, process, and outcomes criteria and 4) provide future research directions in this field. Method: This review followed Joanna Briggs Institute (JBI) updated guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. PubMed, SCOPUS and Web of Science were searched for studies on HL interventions published between 2011-2021 in English and Portuguese language in 44 European countries. Interventions for refugees and healthcare professionals were excluded. The peer review process was ensured. Results: Seven studies were included, 85.5% were implemented in Northern and Western Europe combined, 71.4% targeted female migrants and in-person courses (42.9%) were predominant. The cultural adaptation (content, gender, ethnic/migrant concordance), the active role of the participants during the interventions, the use of written patient information material with an in-person consultation, and the multi-modal recruitment method are identified as strengths in HL interventions. Lack of mental health interventions, exclusion of spouses, and key community decision-makers are identified as gaps. Further research on the type of participatory approach model is needed. Conclusions: The strengths, gaps, and future research directions identified in this scoping review are essential first steps for further research to improve HL interventions for migrants.