title: Comprehensibility of Health-Related Documents for Older Adults with Different Levels of Health Literacy: A Systematic Review.
abstract: A systematic review was conducted to assess the available evidence for the effectiveness of interventions aiming to improve the comprehensibility of health-related documents in older adults (≥50) with different levels of health literacy. Seven databases were searched (2005 forward), and references in relevant reviews were checked. The selection procedure was conducted by 2 independent reviewers. Data extraction and assessment of the quality of the resulting studies were conducted by 1 reviewer and checked for accuracy by a 2nd reviewer. A total of 38 intervention studies had a study population of older adults (n = 35) or made an explicit comparison between age groups, including older adults (n = 3). Inconsistent evidence was found for the importance of design features to enhance the comprehensibility of health-related documents. Only for narratives and multiple-feature revisions (e.g., combining revisions in textual and visual characteristics) did the included studies provide evidence that they may be effective for older adults. Using narrative formats and/or multiple-feature revisions of health-related documents seem to be promising strategies for enhancing the comprehensibility of health-related documents for older adults. The lack of consistent evidence for effective interventions stresses the importance of (a) replication and (b) the use of standardized research methodologies.
authors.affiliation: a Department of Communication and Information Sciences, Faculty of Arts , University of Groningen , Groningen , The Netherlands.
authors.forename: Ruth
authors.initials: R
authors.lastname: Koops van 't Jagt
authors.affiliation: a Department of Communication and Information Sciences, Faculty of Arts , University of Groningen , Groningen , The Netherlands.
authors.forename: John C J
authors.initials: JC
authors.lastname: Hoeks
authors.affiliation: a Department of Communication and Information Sciences, Faculty of Arts , University of Groningen , Groningen , The Netherlands.
authors.forename: Carel J M
authors.initials: CJ
authors.lastname: Jansen
authors.affiliation: b Department of Health Sciences , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands.
authors.forename: Andrea F
authors.initials: AF
authors.lastname: de Winter
authors.affiliation: b Department of Health Sciences , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands.
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
mesh_terms: D032882:Comprehension; D057220:Health Literacy / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic