Evidence map›Paper›PMID 33403622›Full record

SynthesisJournal of general internal medicine2021

What is the Prevalence of Low Health Literacy in European Union Member States? A Systematic Review and Meta-analysis.

V Baccolini, A Rosso, C Di Paolo, C Isonne, C Salerno, G Migliara, G P Prencipe, A Massimi, C Marzuillo, C De Vito and 2 more

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 8 pooled it
38.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

101 citing papers in PubMed, 8 syntheses or guidelines pooled it, 191 citations in OpenAlex.

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  7. Implementing Public Health Strategies-The Need for Educational Initiatives: A Systematic Review.International journal of environmental research and public health · 2021
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  14. Randomized controlled trial on the efficacy of audio-visual health educational materials on CPAP adherence: the AHEAD trial.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022
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41 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

V BaccoliniDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. valentina.baccolini@uniroma1.it.ORCID 0000-0002-7873-7817
A RossoDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
C Di PaoloDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
C IsonneDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
C SalernoDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
G MigliaraDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
G P PrencipeDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
A MassimiDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
C MarzuilloDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
C De VitoDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
P VillariDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
F RomanoDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Sapienza University of Rome · ITAzienda Sanitaria Locale Roma 3 · ITHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany studies have shown that low health literacy (HL) is associated with several adverse outcomes. In this study, we systematically reviewed the prevalence of low HL in Europe.

methodsPubMed, Embase, and Scopus were searched. Cross-sectional studies conducted in the European Union (EU), published from 2000, investigating the prevalence of low HL in adults using a reliable tool, were included. Quality was assessed with the Newcastle-Ottawa Scale. Inverse-variance random effects methods were used to produce pooled prevalence estimates. A meta-regression analysis was performed to assess the association between low HL and the characteristics of the studies.

resultsThe pooled prevalence of low HL ranged from of 27% (95% CI: 18-38%) to 48% (95% CI: 41-55%), depending on the literacy assessment method applied. Southern, Western, and Eastern EU countries had lower HL compared to northern Europe (β: 0.87, 95% CI: 0.40-1.35; β: 0.59, 95% CI: 0.25-0.93; and β: 0.72, 95% CI: 0.06-1.37, respectively). The assessment method significantly influenced the pooled estimate: compared to word recognition items, using self-reported comprehensions items (β: 0.61, 95% CI: 0.15-1.08), reading or numeracy comprehensions items (β: 0.77, 95% CI: 0.24-1.31), or a mixed method (β: 0.66, 95% CI: 0.01-1.33) found higher rates of low HL. Refugees had the lowest HL (β: 1.59, 95% CI: 0.26-2.92). Finally, lower quality studies reported higher rates of low HL (β: 0.56, 95% CI: 0.06-1.07). DISCUSSION: We found that low HL is a public health challenge throughout Europe, where one in every three to almost one in every two Europeans may not be able to understand essential health-related material. Additional research is needed to investigate the underlying causes and to develop remedies. PROSPERO REGISTRATION: CRD42019133377.

Indexed as

Health LiteracyAdultCross-Sectional StudiesEuropeEuropean UnionHumansPrevalenceEuropehealth literacymeta-analysisprevalencesystematic review

Identifiers

PMID33403622
PMCPMC7947142
OpenAlexW3120379184

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.