Health Literacy in Latin America and the Caribbean: A Comprehensive Scoping Review of Research Developments.

Health literacy is critical for reducing inequality and promoting effective implementation of health services and better health outcomes. The health literacy agenda is gaining momentum worldwide, including in Latin America and the Caribbean. However, a comprehensive overview of research developments in the region is lacking. This study aimed to explore the state of the art of health literacy research in Latin America and the Caribbean. A scoping review was conducted in January 2024 drawing upon data from the databases: La Referencia, BVS, PubMed, Web of Science, CINAHL, PsycINFO, and ERIC. The search results were reviewed in Rayyan by all co-authors. The title and abstracts were screened, based on inclusion and exclusion criteria followed by extraction, analysis and synthesis of data according to the research objectives. The search yielded 375 publications including 289 peer-reviewed articles and 86 dissertations and theses. The sample included quantitative (73.9%), qualitative (13.9%), mixed-methods (5.9%), and bibliographic (1.9%) studies and other types of scientific publications (4.5%). Two thirds of the countries published health literacy research. Most originated from Brazil, followed by Mexico, Chile, Peru, and Colombia. There was a marked increase in publications from 2017 onward, reaching a peak in 2022. The most frequently cited definitions were by Sørensen et al. (Sørensen et al in BMC Pub Health 12:80, 2012 and the WHO Health Promotion Glossary (World Health Organization (WHO). (1998). Health promotion glossary.). The prominent research topics included oral health literacy and non-communicable diseases. Other topics include e.g., general health literacy, communicable diseases, functional health literacy, and healthcare literacy. Health literacy was measured 312 times with a variety of established and newly developed instruments. This scoping review highlights progress and challenges concerning health literacy research in Latin America and the Caribbean. The active health literacy research community adopts multiple research strategies, themes and multidisciplinary approaches for adapting health literacy interventions to diverse populations. Brazil and its vibrant health literacy community can inspire the development of health literacy in the region. Ongoing research, policy innovation, and community-based action are needed to maximize health literacy's potential for improving health services, public health, and wellbeing in the region.