title: The correlates of chronic disease-related health literacy and its components among men: a systematic review.
abstract: BACKGROUND
  Chronic diseases drive the burden of disease in many societies, particularly among men. Lifestyle behaviours are strongly associated with chronic disease development, and in a number of countries men tend to engage in more risky behaviours, and have lower health knowledge and attention to prevention, than women. This study investigated the correlates of men's health literacy and its components about major lifestyle-related diseases, namely ischaemic heart disease and type 2 diabetes mellitus, to gain evidence to guide the development of policy and programs to improve men's health.
  
  
  METHODS
  A systematic review was undertaken of observational studies that investigated men's health literacy and its components related to ischaemic heart disease or type 2 diabetes mellitus, and their associated risk factors. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Embase and the Cochrane Library databases were searched for articles published since 2003. The strength of the evidence was rated using the GRADE approach.
  
  
  RESULTS
  After screening and review of 504 articles, the search elicited nine studies for inclusion: only one study examined health literacy (nutrition literacy). The majority of included studies focused on only one component of health literacy, namely knowledge (n = 7) and personal skills (confidence) (n = 1). Twenty correlates were identified, primarily relating to the knowledge component, with the strength of the evidence for only one correlate, education, graded as being of moderate quality. The evidence for all other correlates was graded as being of low quality.
  
  
  CONCLUSIONS
  The limited body of research identified may have resulted from a lack of consensus about the definition of health literacy, and a concordant set of validated health literacy measures. Despite these limitations, broadening the search to include components of health literacy has identified that several factors are associated with men's knowledge and awareness of ischaemic heart disease and type 2 diabetes mellitus that will assist in the development of men's health promotion strategies. However, addressing the broader knowledge gaps and controversy in the health literacy field will deliver policy and program benefits to address these major contributors to the burden of disease among men.
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Lev 6, the Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia. jdavey@daveyco.net.
authors.forename: Jeff
authors.initials: J
authors.lastname: Davey
authors.affiliation: Andrology Australia, School of Public Health and Preventive Medicine, Monash University, Lev 1, 549 St Kilda Road, Melbourne, VIC, 3004, Australia. carol.holden@monash.edu.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Holden
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Lev 6, the Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia. ben.smith@monash.edu.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Smith
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control; D002908:Chronic Disease / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D057220:Health Literacy / Q000379:methods*; D006293:Health Promotion / Q000379:methods; D006304:Health Status; D006801:Humans; D008297:Male; D054526:Men's Health