Professor Mark Harris, Centre for Primary Health Care and Equity, University of New South Wales Funding: Supported by the PHCRED Strategy and APHCRI stream funding Team members: Jane Taggart, Dr Sarah Dennis, Anna Williams, Dr Anthony Newall, Professor Nick Zwar, Dr Elizabeth Denney Wilson, Dr Tim Shortus

Five of the top seven factors contributing to the burden of disease in Australia are lifestyle related – smoking, nutrition, alcohol, physical activity and weight (SNAPW). This represents a significant opportunity to improve people’s health and wellbeing.

People’s decisions and actions to manage their health risk factors are influenced by health literacy, which refers to people’s ability to access and use health information. Higher health literacy skills can enable people to exert greater control over life events and changing situations, such as their management of SNAPW risk factors. Less than half the Australian population has adequate health literacy and improving this rate is a priority in national health and primary care strategies.

This first systematic review of evidence on the effectiveness of health literacy interventions for changing SNAPW risk factors found that health literacy improved in 74% of the interventions. By identifying the health literacy interventions that changed SNAPW behaviours, findings of this review provide significant new knowledge about the types of interventions (both group and individual) that are effective and may be suited to the needs of different people. For example, group or multiple interventions and those using written materials were more likely to result in changes in nutrition, while individual counselling and motivational interviewing were more likely to result in changes in smoking and physical activity. Of particular interest is that more complex or  intense health literacy interventions are not necessarily better.

The findings have been provided to national, state and local health services and policymakers and have informed future research aimed at enhancing preventive care in disadvantaged communities.