JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic has placed a significant burden on healthcare professionals (HPs). They face higher infection risks due to the nature of their work environment and patient care responsibilities. Their ability to access and apply reliable COVID-19 information affects their preventive behaviour and that of those around them. In this context, health literacy (HL), particularly related to communicable diseases such as COVID-19, has become increasingly important. Despite extensive research on HL during the pandemic, there is still al lack of information on targeted interventions aimed at fostering COVID-19-related HL in HPs.

Objective:

This systematic review aimed to identify, appraise, and synthesise intervention studies on the effectiveness of COVID-19-related HL interventions in HPs.

Methods:

Five electronic databases (e.g. PubMed (MEDLINE®), EMBASE) and six clinical trials registries (e.g. ISRCTN registry) were searched. Reference lists of included studies were manually searched. Two reviewers independently screened titles, abstracts and full-texts according to eligibility criteria and performed data extraction, with disagreements resolved by a third reviewer. We included studies that intended to improve COVID-19-related HL in general, any facet (access, understand, appraise, and apply pandemic information) or indicator (e.g. knowledge, skills). Meta-analysis was performed where assumptions were met; otherwise, a narrative synthesis was provided. Risk of bias was assessed using validated tools based on study design, and the overall certainty of the evidence was evaluated by the ‘Grading of Recommendation, Assessment, Development, and Evaluation’ (GRADE) approach.

Results:

We included 13 RCTs, four NRSI, 61 uncontrolled before-after studies and six ongoing-studies (285,879 participants). Interventional studies targeted a broad range of health occupational groups. The type of intervention, delivery mode and methods, settings, and comparator varied widely. No study explicitly referred to an HL model. The majority aimed to enhance COVID-19-related knowledge and skills. Most studies had a high risk of bias. COVID-19-related interventions may increase knowledge of vaccines (SMD = 1.00; 95% CI [0.69, 1.31], I2= 24%), and the infection prevention control skills of donning and doffing of personal protective equipment (SMD = 1.95; 95% CI [1.43, 2.48], I2= 46%), but the evidence remains very uncertain.

Conclusions:

COVID-19-related HL interventions may contribute to promote HP’s short-term competencies in infection control. However, the evidence remains uncertain, primarily due to low quality of studies, characterised by a high risk of bias. Interventions specifically designed to enhance the full COVID-19 health literacy construct with its four facets are still lacking. To achieve a more precise understanding, high-quality RCTs with sufficient statistical power, grounded in the theoretical principles of HL, are needed. Clinical Trial: PROSPERO registration number CRD42022301810