MODELOS E EFEITOS DE INTERVENÇÕES DE LETRAMENTO EM SAÚDE PARA PESSOAS IDOSAS: UMA REVISÃO SISTEMÁTICA COM METANÁLISE

Abstract

Low health literacy is a public health problem that affects the entire population, especially the older adults. This construct refers to the ability of individuals to access, understand, evaluate, and apply health-related information in written, spoken, and typed form. Different interventions focused on health literacy have been developed to improve this construct in older adults and, thus, enable better behaviors related to care and self-care. In addition, to minimize other impairments (e.g., cognitive, related to mental health). Objective: To conduct a systematic review with meta-analysis to identify health literacy intervention models carried out with older adults. Method: This is a systematic review using the LILACS, PsycINFO, PubMed, Scopus, and Web of Science databases. The following search strategy was used: “"health literacy" AND ("education" OR "training" OR "intervention") AND ("aged" OR "older adult" OR "elderly")”. Results: A total of 16,378 articles were identified in the databases, of which 7,038 were excluded due to duplication. After screening by title and abstract, 126 articles were selected for full reading and 18 studies were included in the review, 10 of which were quasi-experimental and eight were experimental. Among the experimental studies, only one presented high quality and low risk of bias; five had moderate risk and two, high risk of bias. Of the 10 quasi-experimental studies, eight presented high quality and low risk of bias and two were assessed as having moderate risk of bias. In total, the studies included 2,256 older adults, with a mean or median age between 65.9 and 81.7 years in 77.8% of the studies. In 38.9% of the cases, the samples included older adults with chronic conditions. Of the 18 studies, 15 reported positive effects of health literacy interventions. The meta-analysis confirmed the positive impacts, both in the pre- and post-intervention comparison and in the comparison of the intervention group with the control group. Other beneficial outcomes included quality of life, health behaviors, self-care, self-efficacy, and depressive symptoms. Conclusion: The review demonstrated that well-structured educational interventions contribute significantly to the promotion of health literacy, also favoring quality of life, autonomy, self-care, and the improvement of several health outcomes among older adults. Impacts of the Research and Implications for Practice: Despite the different models and approaches used, the results reinforce the importance of incorporating health literacy as a central component of public policies aimed at healthy aging. In addition, the need to support researchers and health professionals in the development and implementation of educational strategies in contexts such as Primary Health Care, which is the “gateway” to the Unified Health System, promoting evidence-based practices that expand access to information, active participation, and comprehensive care for the older population, is highlighted. Future studies should explore the effectiveness and applicability of these interventions in different contexts, especially in Brazil.