Health literacy interventions for pregnant women with limited language proficiency in the country they live in: a systematic review,BMC Public Health

Low health literacy can present significant risks throughout pregnancy, impacting both maternal and fetal health outcomes. Those who do not speak the main language of their country of residence are more likely to have lower health literacy. Considering the heightened challenges faced by this demographic in accessing, understanding, and engaging with health information and services, designing and implementing tailored interventions is crucial to mitigate health disparities. This review aims to identify and examine health literacy interventions developed for pregnant women whose first language differs from the language predominantly spoken in their residing country. Electronic databases of Embase and Medline were searched using relevant search terms from their inception to July 2023. Data were extracted and analysed using narrative synthesis. Of the 1964 identified records, three were included. The studies were conducted in Australia and Denmark, and ranged in design, including: a cluster randomised controlled trial, mixed methods design; and qualitative design. Health literacy intervention modalities included midwifery education combined with a smartphone application and leaflet, culturally adapted group classes, and informative videos. The interventions were translated into various languages to cater to the target populations. Two studies used the Health Literacy Questionnaire to assess the intervention effectiveness, yielding contrasting results: one showed no improvement, while the other reported increased post-intervention health literacy scores. The third had not yet evaluated intervention effectiveness. This review identifies a significant scarcity in health literacy interventions for pregnant women whose first language differs to the predominant language of the country they live in, despite their greater need for support. While few studies were found, their diversity suggests multiple strategies for enhancing health literacy. Bridging this health literacy gap for linguistically diverse pregnant populations could reduce disparities in maternal and fetal outcomes, underscoring the need for targeted, evaluated interventions that actively engage affected women and their support networks. Registered with PROSPERO: CRD42023475511. Date of registration: 10.11.23.

中文翻译：

对其居住国语言能力有限的孕妇的健康素养干预：系统评价

健康素养低会在整个怀孕期间带来重大风险，影响母体和胎儿的健康结果。那些不会说居住国主要语言的人更有可能具有较低的健康素养。考虑到这一人群在获取、理解和参与健康信息和服务方面面临的巨大挑战，设计和实施量身定制的干预措施对于减轻健康差异至关重要。本综述旨在确定和检查为第一语言与其居住国主要使用的语言不同的孕妇开发的健康素养干预措施。使用相关检索词检索了 Embase 和 Medline 的电子数据库，检索时间从建库到 2023 年 7 月。使用叙述综合提取和分析数据。在 1964 年确定的记录中，包括 3 项。这些研究在澳大利亚和丹麦进行，设计范围广泛，包括：整群随机对照试验，混合方法设计;和定性设计。健康素养干预方式包括助产教育与智能手机应用程序和传单相结合、适应文化的小组课程和信息视频。干预措施被翻译成各种语言，以迎合目标人群。两项研究使用健康素养问卷来评估干预效果，得出了截然不同的结果：一项显示没有改善，而另一项报告干预后健康素养得分增加。第三项研究尚未评估干预效果。 本综述发现，尽管她们更需要支持，但对于第一语言与所居住国家的主要语言不同的孕妇，健康素养干预措施非常稀缺。虽然发现的研究很少，但它们的多样性表明了提高健康素养的多种策略。弥合语言多样化的孕妇群体的健康素养差距可以减少母体和胎儿结局的差异，强调需要有针对性、经过评估的干预措施，以积极参与受影响的妇女及其支持网络。在 PROSPERO 注册：CRD42023475511。注册日期：10.11.23。

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