title: Health Literacy in Older Latinos With Heart Failure: A Systematic Review.
abstract: BACKGROUND
  By 2050, one-third of US residents will be Latino, with an incidence of heart failure (HF) higher than other ethnicities. Culturally linked risk factors and socioeconomic challenges result in cardiometabolic risks, healthcare disparities, and worsening health outcomes. Individuals with low health literacy (HL) and HF are less likely to possess tools for optimal self-care, disease management, or preventative health strategies.
  
  
  OBJECTIVE
  In this systematic review, we analyzed the literature studying older Latinos with HF and limited HL.
  
  
  METHODS
  We searched the literature and used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in an iterative process. Inclusion criteria were research studies, Latinos, HF, and HL.
  
  
  RESULTS
  Eight quantitative studies were identified for final review. Inadequate HL was reported in 87.2% of elderly Latinos. Higher HL was associated with more HF knowledge. Clinics serving minorities reported lower HL levels and higher medical complexity.
  
  
  CONCLUSIONS
  Nurses and advanced practice nurses serve a pivotal role improving access and understanding of health information. Before conducting intervention research affecting clinical outcomes, it is essential to describe elderly Latinos with HF and their HL and self-care levels. Barriers identified confirm the need to alter research protocols for older adults and ensure the availability of assistive devices. The need to examine HL in older Latinos with HF is confirmed by the medical complexity of ethnic minority patients with limited HL, limited HL in the elderly, and the relationship of HL with HF knowledge. In culturally diverse populations, HL levels alone may not be reliable predictors of a person's ability to self-manage, recognize symptoms, and develop, implement, and revise a self-care action plan to manage their health.
authors.affiliation: Janet M. Delgado, MN, RN, ACNP, ANP, ACNS, CHFN PhD Candidate, University of Missouri-Sinclair School of Nursing, Columbia. Todd M. Ruppar, PhD, RN, GCNS-BC, FAHA Assistant Professor and Robert Wood Johnson Foundation Nurse Faculty Scholar, University of Missouri-Sinclair School of Nursing, Columbia.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Delgado
authors.forename: Todd M
authors.initials: TM
authors.lastname: Ruppar
mesh_terms: D000368:Aged; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D057220:Health Literacy; D006333:Heart Failure / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans