Health literacy, health literacy interventions and decision-making: a systematic literature review
| DOI | https://doi.org/10.1108/JD-01-2022-0004 |
| Published date | 24 June 2022 |
| Date | 24 June 2022 |
| Pages | 405-428 |
| Subject Matter | Library & information science,Records management & preservation,Document management,Classification & cataloguing,Information behaviour & retrieval,Collection building & management,Scholarly communications/publishing,Information & knowledge management,Information management & governance,Information management,Information & communications technology,Internet |
| Author | Maedeh Ghorbanian Zolbin,Isto Huvila,Shahrokh Nikou |
Health literacy, health literacy
interventions and
decision-making: a systematic
literature review
Maedeh Ghorbanian Zolbin
Department of Information Studies, Faculty of Social Sciences,
Business and Economics,
Abo Akademi University, Turku, Finland
Isto Huvila
Department of ALM, Uppsala University, Uppsala, Sweden, and
Shahrokh Nikou
Department of Information Studies, Faculty of Social Sciences,
Business and Economics,
Abo Akademi University, Turku, Finland and
Department of Computer and Systems Sciences, Stockholm University,
Stockholm, Sweden
Abstract
Purpose –The purpose of this paper is to assess the relationship betweenelderly people’s health literacy skills
and those people’s decision to make use of digital health service platforms. Despite the substantial influence of
digitisation on the delivery of healthcare services, understanding how health intervention strategies might help
empower elderly people’s health literacy skills is critical.
Design/methodology/approach–This paper analyses the existing trends in research on the convergence of
health literacy, health intervention programmes and digital health service platforms by reviewing 34 studies
published between 2000 and 2020.
Findings –The findings of the review indicate three primary themes (health literacy skills, health
management competency and attitude/confidence), which provide a summary of the current literature, and in
all three the results show that health intervention programmes help to enhance health literacy skills of elderly
people. Based on the review results and by organising the fragmented status quo of health intervention
research, the authors develop a comprehensive research model and identify future research directions for
research in this domain.
Practical implications –The findings will be useful to health professionals in two ways: (1) the findings
provide practical information about the growing need to implement health literacy intervention programmes to
satisfy elderly people’s appetite for accessing health services due to cognitive and physiological impairments,
and (2) the finding help them to understand that with digital health platforms, elderly people have quicker
access to health services, improving the quality of care provided to them.
Originality/value –This paper presents a comprehensive research model for analysing the impact of health
literacy skills on older people’s ability and intention to access digital health information sources, considering
various health intervention approaches.
Keywords Health literacy, Elderly people, Health decision-making, Health interventions, Digitalisation,
E-Health services
Paper type Literature review
Health
literacy’s
literature
review
405
© Maedeh Ghorbanian Zolbin, Isto Huvila and Shahrokh Nikou. Published by Emerald Publishing
Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone
may reproduce, distribute, translate and create derivative works of this article (for both commercial and
non-commercial purposes), subject to full attribution to the original publication and authors. The full
terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode
Received 7 January 2022
Revised 18 May 2022
Accepted 19 May 2022
Journal of Documentation
Vol. 78 No. 7, 2022
pp. 405-428
Emerald Publishing Limited
0022-0418
DOI 10.1108/JD-01-2022-0004
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/0022-0418.htm
1. Introduction
Over the last few years, the average human lifespan has increased, and the number of
individuals aged 65 and over has risen significantly (Bhattarai and Phillips, 2017). As people
age, they become more susceptible to difficult conditions (e.g. arthritis, heart disease, cancer
and diabetes) (Martin et al., 2010), which may contribute to impaired quality of life and an
increased likelihood of fatality (Mueller et al., 2020). One way to tackle this issue and help
elderly people to enjoy a healthier life is to empower them with the essential skills and abilities
to use available digital health services (e.g. e-health or m-health) (Jackson et al., 2020). Digital
health services provided through digital health platforms enable individuals to access a large
amount of health-related information and allow them to manage their chronic diseases more
easily (Sarfati et al., 2018). For example, by using online health information and digital health
platforms, elderly diabetic patients could considerably improve their understanding of their
health condition(s) (e.g. diet, exercise, medication adherence) and gain better control over such
conditions (Long and Gambling, 2012). Therefore, it is important to understand how elderly
people’s quality of life can be improved by using digital health services and online health
platforms. And it is also important to understand the skills needed to empower elderly people
to use digital health services and absorb the available health information on digital platforms
and apply the knowledge gained to manage their own health, address their potential health
problems, and make more appropriate and informed health decisions (Goeman et al., 2016).
The empirical evidence in the literature demonstrates that to access and use digital health
services, literacy skills –particularly health literacy or e-health literacy –are vital (Gross et al.,
2007;Xie et al., 2020;Zimmerman, 2021). Both terms “health literacy”and “e-health literacy”in
the contemporary literature and in practice refer to the ability of individuals to deal with
health information (Del Giudice et al., 2018), these two terms will be used interchangeably in
this paper. The literature indicates that health literacy skills are often less well developed
among elderly people (65þ)(Yang et al., 2019); therefore, they utilise fewer technology–based-
health services and online health platforms (Xie et al., 2020). In this regard, several researchers
emphasise that one way of overcoming such problems is to improve health literacy among
elderly people; for instance, through intervention programmes (Banbury et al., 2019;Kim
et al., 2014). The research results have shown that improvement of health literacy skills from
pre-to post-intervention phases among elderly people (Xie, 2012), empowers them to locate
and identify trustworthy health resources (Xie and Bugg, 2009), maintain or enhance their
self-management skills (Vogt et al., 2017), reduce risky behaviours (Liu et al., 2015), resolve
health-related problems, and make informed health decisions, which in turn lead to a better
quality of life and improved health status (Park et al., 2018).
While there has been a noticeable increase in the number of publications regarding
digitalisation, and the health literacy of elderly people in recent years (Shiet al., 2021;Watkins
and Xie, 2014). However, there is a lack of studies that holistically examine and synthesisethe
relationships between health literacy, intervention programmes, use of digital health
services, and health decision-making in the context of elderly people. This gap in the research
is even more obvious when it comes to personal (lack of experience with digital health
platforms) and infrastructure (limited access to digital tools) obstacles, as well as how
intervention programs might help elderly people to improve their health status. Thus, this
paper performs a systematic literature review with threefold objectives: (1) reviewing state-of-
the-art literature concerning the relationship between health literacy, elderly people,
intervention programmes, use of digital health services, and health decision-making to
identify the outcomes of such relationships at both personal and societal levels; (2) exploring
the strategies (methods) used in existing health literacy interventions and determine which
form of content mediation style (type of information delivery) might be more effective in
improving health literacy among elderly people; and (3) identifying barriers (personal and
infrastructural) hindering the improvement of health literacy among elderly people via the
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