Effectiveness of Interventions to Improve Digital Health Literacy in Forced Migrant Populations: Mixed Methods Systematic Review.

backgroundDigital health literacy (DHL), recognized as a key determinant of health, can influence health and well-being, improve health equity, and reduce health disparities. However, DHL is often limited among forced migrant populations, who usually lack the skills to understand and evaluate health information or to access and use digital health resources appropriately.

objectiveWe aimed to (1) identify effective interventions designed to improve DHL among forced migrant populations and (2) categorize and describe the characteristics of interventions that aim to improve the abilities of forced migrants or adapt digital health services to meet the needs and expectations of forced migrant populations limited by low levels of DHL.

methodsWe conducted a mixed methods systematic review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, involving an iterative process among the authors. A medical information specialist assisted in developing a search strategy for the 6 most relevant databases (MEDLINE, Embase, CINAHL, Web of Science, Academic Search Premier, and PsycINFO) and the Google Scholar search engine, covering studies published between 2000 and 2022. Pairs of reviewers selected, individually and independently, titles, abstracts, and then full texts. Data extraction and quality assessment were performed by 2 reviewers and validated by a senior researcher. We used narrative synthesis to provide a comprehensive overview of effective DHL interventions for forced migrant populations, highlighting their success factors.

resultsWe identified 1845 studies, of which only 6 (0.33%) were finally selected for narrative synthesis. Studies were excluded due to irrelevance, lack of primary data, or low methodological quality. The analysis revealed a diverse methodological landscape with a predominance of qualitative approaches aimed at understanding the challenges and needs of forced migrants concerning DHL. The main challenges were associated with cultural, linguistic, and practical contexts. Interventions targeted various groups, including older adults, individuals with low literacy or education, and those with limited digital experience. We identified 4 effective educational intervention categories to enhance DHL among forced migrants: education and training; education and social support; enabling and education; and social, educational, technological, and infrastructural support. Overall, most of the studies (5/6, 83%) reported positive results in terms of improving DHL among forced migrants.

conclusionsThis systematic review highlights the importance of improving DHL among forced migrant populations to promote their health and well-being. In addition, it provides comprehensive knowledge about effective interventions conducted with these groups. These findings can inform stakeholders, particularly policy makers, of the need to address low DHL among forced migrant populations. Going forward, these stakeholders need to develop innovative initiatives that rely on holistic approaches and are based on the specific needs of forced migrants to improve equity and health outcomes.

trial registrationPROSPERO CRD42022373448; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022373448. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/50798.