Health Literacy Interventions

Systematic review of health literacy interventions: Identifying health literacy interventions that reduce the use of primary care and emergency services for minor health issues.



Health literacy is a person’s ability to get hold of, understand and act on health information. Can people find the information they need? Can people understand what they find? Can people use what they find to meet their needs? It is not about people’s intelligence levels or how long they have stayed in full time education.

Previous research has shown that people with lower levels of health literacy are more likely to use primary care and emergency services for minor health problems. The aim of the research is to identify interventions that improve health literacy and, through doing this, reduce the use of general practice, emergency ambulances and emergency departments for minor health problems such as coughs, or diarrhoea and vomiting. It is important to do this because general practitioners (GPs) and emergency services in the UK are dealing with higher levels of demand than they can cope with. Reducing demand for these services for minor problems may help services to deal with patients with more major problems.

Following on from our study of demand for emergency and urgent care (DEUCE, Project website). We are undertaking a systematic review of studies that have evaluated interventions to improve health literacy in ways that reduce use of primary and emergency care for minor problems. Interventions may include written information, educational workshops, digital interventions and mass media campaigns. These might take place in different settings such as primary care and emergency department staff delivering interventions, training and support within the community, or national media campaigns. 

As part of the review process, we will bring together the results of the different studies and also assess the interventions such as how easy they are to read. Through looking at different interventions we hope to understand which interventions are most beneficial and could be used within the UK (and beyond) to improve people’s health literacy. We will consider issues like where the support is delivered, how much it costs and who the intervention is aimed at.  We will also consider whether patients, the public and staff find the approach acceptable and suitable. 

Throughout the study we are talking to stakeholders including the public, clinicians, service providers and those responsible for ensuring services are available to the population. For example, we are working with NHS Health Literacy Clinical Lead.  Stakeholders are providing ideas about what interventions may help to increase health literacy. We will discuss the findings of the review with stakeholders to identify how the findings of the review may be relevant to the UK. 

The findings of the review will be disseminated to stakeholders and published in academic journals. 

Patient and public involvement

We are involving patients and the public throughout the review. This includes: 

1. Having a patient who is part of the review team.

2. Discussing plans, emerging findings and dissemination with our Patient and Public Involvement group (this include patients, carers and members of the public). 

3. Holding two stakeholder events where patients, members of the public, clinicians and decision-makers to discuss the review. For example, their opinions on which interventions may be suitable for the UK.

4. Having regular newsletters to our stakeholders to keep them informed about the progress of the study and to provide an opportunity for people to provide feedback on what we are doing. 


Health Literacy Interventions newsletter - Issue 1, January 2021

Project dates

The review is being conducted between November 2020 and December 2021. 

Research team

  • Professor Alicia O’Cathain (Lead investigator)
  • Dr Chris Carroll (Project manager/Lead reviewer)
  • Dr Louise Preston (Review methodologist)
  • Mark Clownes (Information specialist)
  • Professor Joanne Protheroe (Health Literacy specialist)
  • Dr Alexis  Foster (Stakeholder lead)
  • Margaret Ogden (Patient and Public involvement representative)
  • Veronica Fibisan (Study administrator)


Health Services and Delivery Research Programme (Reference: NIHR131238)

Further details

For further details about this work, please contact Veronica Fibisan (Study administrator) at