Effectiveness of Musculoskeletal Education Interventions in People With Low Literacy Levels: A Systematic Review
Article first published online: 27 NOV 2013
© 2013 The Authors. Arthritis Care & Research is published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.
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Arthritis Care & Research
Volume 65, Issue 12, pages 1976–1985, December 2013
How to Cite
Lowe, W., Ballinger, C., Protheroe, J., Lueddeke, J., Nutbeam, D., Armstrong, R., Falzon, L., Edwards, C., Russell, C., McCaffery, K. and Adams, J. (2013), Effectiveness of Musculoskeletal Education Interventions in People With Low Literacy Levels: A Systematic Review. Arthritis Care Res, 65: 1976–1985. doi: 10.1002/acr.22085
- Issue published online: 27 NOV 2013
- Article first published online: 27 NOV 2013
- Accepted manuscript online: 7 AUG 2013 12:42PM EST
- Manuscript Accepted: 3 JUL 2013
- Manuscript Received: 15 JAN 2013
- Arthritis Research UK
To conduct a systematic review to assess the effectiveness of patient education interventions delivered or directed by health professionals for people with musculoskeletal conditions who also have lower levels of literacy.
Electronic databases were searched from 1946 to May 2012. Randomized controlled trials with primary interventions designed specifically for individuals with musculoskeletal conditions and lower levels of literacy were eligible for inclusion. The quality of the study was determined by assessing method of randomization, allocation concealment, creation and maintenance of comparable groups, blinding of patients and providers, control of confounding, and the validity and reliability of outcome measures.
Of the 2,440 studies located using the search strategy, 6 studies met the inclusion criteria. Three public health community studies and 3 rheumatology clinic-based studies delivered educational programs to people with musculoskeletal conditions who also had lower levels of literacy. Three moderate quality studies suggest that musculoskeletal educational interventions had a small short-term effect on knowledge and 2 moderate quality studies suggest musculoskeletal interventions had a small effect on self-efficacy (although results on self-efficacy were conflicting in 1 of these studies). Only 1 moderate quality study showed a small effect on anxiety and 1 on self-perceived health and well-being in people with lower literacy.
High quality evidence is lacking on the effectiveness of musculoskeletal education interventions for people with lower literacy levels. Research programs that test the effectiveness of patient education interventions for arthritis must recruit and engage people with lower levels of literacy.