Community-based initiatives improving critical health literacy: a systematic review and meta-analysis of qualitative evidence.

Background:

Critical health literacy enables older adults to make informed health decisions and take actions
for the health and wellbeing of themselves and their community, within their own social and cultural context.
A community-based approach has the potential to improve the critical health literacy of older adults and their
communities. However, it is not clear how such initiatives consider critical health literacy. Therefore, this study
explored how community-based initiatives address the critical health literacy of older adults and their communities.

Methods:

A systematic literature search was conducted. Two reviewers independently screened titles and
abstracts, as well as the quality of the methodological and community-based elements of the studies. In addition,
a meta-synthesis was carried out, consisting of a qualitative text analysis of the results sections of the 23 included
studies.

Results:

We identified two main themes, which are practices that contribute to the critical health literacy of older
adults as well as their communities: 1) collaborative learning, and 2) social support. In these practices we
identified reciprocity as a key characteristic of both co-learning and social support.

Conclusions:

This study provides the first overview of community-based initiatives that implicitly address the
critical health literacy of older adults and their community. Our results demonstrate that in the context of one’s
own life collaborative learning and social support could contribute to people’s understanding and ability to
judge, sift and use health information. We therefore suggest to add these two practices to the definition of
critical health literacy.