title: Healthy ageing in Europe: prioritizing interventions to improve health literacy.
abstract: BACKGROUND
  Health literacy (HL) is low for 40-50 % of the population in developed nations, and is strongly linked to many undesirable health outcomes. Older adults are particularly at risk. The intervention research on health literacy in ageing populations project systematically created a large inventory of HL interventions targeting adults age 50+ , to support practical production of policy and practice guidelines for promoting health literacy in European populations.
  
  
  METHODS
  We comprehensively surveyed international scientific literature, grey literature and other sources (published 2003+) for implemented HL interventions that involved older adults. Studies were screened for eligibility criteria and further selected for aspects important in European public health policy, including priority diseases, risk factors and vulnerable target groups. Interventions were prioritised using a multiple criteria tool to select final interventions that also featured strong evidence of efficacy and a broad range of strategies.
  
  
  RESULTS
  From nearly 7000 written summaries, 1097 met inclusion criteria, of which 233 were chosen for scoring and ranking. Of these, seven had the highest multi-criteria scores. Eight more articles were selected based on rounded criteria including a high multi-criteria score as well as elements of innovation. Final selections were 18 articles describing 15 programmes, which feature strong evidence of efficacy among important diseases or risk factors and vulnerable groups, or that had success with elements of innovation were identified. Most programmes tried to increase skills in communication, self-management and understanding healthcare or lifestyle choices.
  
  
  CONCLUSIONS
  These programmes have multiple positive attributes which could be used as guidance for developing innovative intervention programmes to trial on European older adults. They provide evidence of efficacy in addressing high priority diseases and risk factors.
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK. j.brainard@uea.ac.uk.
authors.forename: Julii
authors.initials: J
authors.lastname: Brainard
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
authors.forename: Yoon
authors.initials: Y
authors.lastname: Loke
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Salter
authors.affiliation: Hungarian National Institute for Health Development, Budapest, 1437, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Koós
authors.affiliation: Hungarian National Institute for Health Development, Budapest, 1437, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Csizmadia
authors.affiliation: Hungarian National Institute for Health Development, Budapest, 1437, Hungary.|Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pécs, 7621, Hungary.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Makai
authors.affiliation: Hungarian National Institute for Health Development, Budapest, 1437, Hungary.|Department of Behavioural Sciences, University of Pécs Medical School, Pécs, 7624, Hungary.
authors.forename: Boróka
authors.initials: B
authors.lastname: Gács
authors.affiliation: Hungarian National Institute for Health Development, Budapest, 1437, Hungary.|Institute of Behavioural Sciences, Semmelweis University Budapest, Budapest, 1089, Hungary.
authors.forename: Mária
authors.initials: M
authors.lastname: Szepes
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D005060:Europe; D057220:Health Literacy; D006292:Health Priorities; D006801:Humans; D008875:Middle Aged
keywords: Health literacy; Multi-criteria decision aid; Older adults; Prioritisation exercise