Exploring the Interplay of Health Literacy and Non-Communicable Disease Health Outcomes in Southeast Asia: A Systematic Review
Abstract
Background: Non-communicable Diseases (NCDs) present a substantial challenge in low- and middle-income nations, especially in the Southeast Asia region. Health literacy (HL) is vital for managing NCDs and improving health outcomes by enhancing individuals' abilities to seek, understand, assess, and utilize health information.
Methods: A systematic review followed PRISMA guidelines, and relevant articles were sourced from PubMed, ProQuest, CINAHL, Scopus, Cochrane, and Google Scholar without limiting the publication year. Studies included were from Southeast Asia that examined the connection between HL and NCD outcomes. Sixteen cross-sectional studies from five countries were chosen for the final analysis.
Results: The review observed that higher HL was linked to better health outcomes for individuals with NCDs. Communicative and critical HL were found to be more impactful than functional HL in obtaining, analysing, and applying health information. Additionally, HL was influenced by sociodemographic aspects (age, gender, education, location, and marital status, socioeconomic factors (income and employment), and societal influences (patient-doctor relationships, cultural context, and family support). HL was important in managing NCDs and for better health outcomes.
Conclusion: Further studies are called for the evaluation of all three HL skills to comprehensively understand the HL of populations. Furthermore, the link between limited HL and employment status remains under-explored and deserves further attention.
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2. Centers for Disease Control and Prevention (2019). Understanding health literacy. Place of publication. Available from: https://www.cdc.gov/health-literacy/php/about/understanding.html
3. Peerson A, Saunders M (2009). Health literacy revisited: What do we mean and why does it matter? Health Promot Int, 24 (3): 285-96.
4. World Health Organization (2023). Ninth global conference on health promotion. Available from: https://www.who.int/teams/health-promotion/enhanced-wellbeing/ninth-global-conference
5. Abel T, Apfel F, Böcken J, et al (2013).Health literacy: The solid facts. WHO Regional Office for Europe. Denmark.
6. World Health Organization (2023). Non-communicable diseases. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
7. World Health Organization (2019). Noncommunicable diseases in South-East Asia. Available from: https://www.who.int/southeastasia/health-topics/noncommunicable-diseases
8. Rajah R, Hassali MAA, Murugiah MK (2019). A systematic review of the prevalence of limited health literacy in Southeast Asian countries. Public Health, 167:8-15.
9. Aljassim N, Ostini R (2020). Health literacy in rural and urban populations: A systematic review. Patient Educ Couns, 103 (10): 2142-54.
10. O'Conor R, Moore A, Wolf MS (2020). Health Literacy and its impact on health and healthcare outcomes. Stud Health Technol Inform, 269:3-21.
11. Bruand P-E, Magne J, Guerchet M, Aboyans V, Preux P-M (2023). Health literacy in low and middle income countries. International Journal of Noncommunicable Diseases, 8 (4): 226-32.
12. Joanna Briggs Institute (2020). Critical appraisal tools. Available from: https://jbi.global/critical-appraisal-tools
13. Goplen CM, Verbeek W, Kang SH, et al (2019). Preoperative opioid use is associated with worse patient outcomes after total joint arthroplasty: A systematic review and meta-analysis. BMC Musculoskelet Disord, 20 (1): 234.
14. Khatiwada B, Rajbhandari B, Mistry SK, et al (2022). Prevalence of and factors associated with health literacy among people with non-communicable Diseases (NCDs) in South Asian countries: A systematic review. Clin Epidemiol Glob Health, 18:101174.
15. Cheah YK, Su TT (2012). The determinants of consumer health information on chronic non-communicable disease: An exploratory study in Penang, Malaysia. Journal of the University of Malaya Medical Centre, 15 (2): 1-7.
16. Dinh HTT, Nguyen NT, Bonner A (2020). Health literacy profiles of adults with multiple chronic diseases: A cross‐sectional study using the health literacy questionnaire. Nurs Health Sci, 22 (4): 1153-1160.
17. Piwpong R, Marungsee S, Sungsrikaw T, Jhornlumkone B (2023). A study of health literacy and clinical outcomes of older adults with hypertension and diabetes in Northeastern communities, Thailand. Journal for ReAttach Therapy and Developmental Diversities, 6 (3s): 683-690.
18. Suarilah I, Lin CC (2022). Factors influencing self-management among Indonesian patients with early-stage chronic kidney disease: A cross-sectional study. J Clin Nurs, 31 (5-6): 703-715.
19. Tan WY, Ismail M (2020). Health literacy among adult type 2 diabetes mellitus (T2dm) patients in Kang health district Malaysia. Journal of Health and Translational Medicine, 23:245-253.
20. Medyati N, Amiruddin R, Arsunan A, et al (2019). Health literacy as a risk predictor of cardiovascular diseases among informal sector workers in Makassar city. Indian Journal of Public Health Research & Development, 10 (2).
21. Rahmawati R, Amiruddin R, Zulkifli A, et al (2021). The effect of communicative and critical health literacy on primary stroke prevention behavior of patients with hypertension. Linguistica Antverpiensia.
22. Rachmawati U, Sahar J, Wati DNK (2019). The association of diabetes literacy with self-management among older people with type 2 diabetes mellitus: a cross-sectional study. BMC Nurs, 18 (Suppl 1): 34.
23. Wannasirikul P, Termsirikulchai L, Sujirarat D, et al (2016). Health literacy, medication adherence, and blood pressure level among hypertensive older adults treated at primary health care centers. Southeast Asian J Trop Med Public Health, 47 (1): 109-20.
24. Asharani P, Lau JH, Roystonn K, et al (2021). Health literacy and diabetes knowledge: A nationwide survey in a multi-ethnic population. Int J Environ Res Public Health, 18 (17): 9316.
25. Ong-Artborirak P, Seangpraw K, Boonyathee S, et al (2023). Health literacy, self-efficacy, self-care behaviors, and glycemic control among older adults with type 2 diabetes mellitus: a cross-sectional study in Thai communities. BMC Geriatr, 23 (1): 297.
26. Froze S, Arif MT, Saimon R (2019). Determinants of health literacy and healthy lifestyle against metabolic syndrome among major ethnic groups of Sarawak, Malaysia: A multi-group path analysis. Open Public Health Journal, 12 (1): 172-83.
27. Jaafar N, Perialathan K, Krishnan M, et al (2021). Malaysian health literacy: Scorecard performance from a national survey. Int J Environ Res Public Health, 18 (11): 5813.
28. Sornlorm K, Thi WM (2024). Health literacy and high blood pressure among Myanmar migrant workers in Northeastern Thailand. PLoS One, 19 (4): e0302057.
29. Dai Minh L, Quang BV, Ngoc Le Mai D, et al (2022). Health literacy of newly-admitted cancer patients in Vietnam: Difficulties understanding treatment options and processing health-related information. Health Serv Insights, 15: 11786329211067325.
30. Lai AY, Ishikawa H, Kiuchi T, Mooppil N, Griva K (2013). Communicative and critical health literacy, and self-management behaviors in end-stage renal disease patients with diabetes on hemodialysis. Patient Educ Couns, 91 (2): 221-7.
31. Nutbeam D (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15 (3).
32. Mirczak A (2022). Functional, communicative and critical health literacy among older Polish citizens. Med Pr, 73 (3): 191-199.
33. Das S, Mia MN, Hanifi SM, et al (2017). Health literacy in a community with low levels of education: Findings from Chakaria, a rural area of Bangladesh. BMC Public Health, 17(1):203.
34. Heijmans M, Waverijn G, Rademakers J, et al (2015).Functional, communicative and critical health literacy of chronic disease patients and their importance for self-management. Patient Educ Couns, 98(1):41-48.
35. Shahid R, Shoker M, Chu LM, et al (2022). Impact of low health literacy on patients' health outcomes: A multicenter cohort Study. BMC Health Serv Res, 22 (1): 1148.
36. Cartwright LA, Dumenci L, Cassel JB, et al (2017). Health literacy is an independent predictor of cancer catients' hospitalizations. Health Lit Res Pract, 1 (4): e153-e62.
37. Radhi MM, Balat KZ (2024). Health literacy and its association with medication adherence in patients with hypertension: A mediating role of social support. Iranian Rehabilitation Journal, 22 (1): 117-127.
38. Al-Ali NM, Telfah RK (2023). The effect of health literacy in explaining medication adherence among patients with hypertension: A cross-sectional study of Syrian refugees in Jordan. Int J Nurs Pract, 29 (3): e13136.
39. Lee YM, Yu HY, You MA, Son YJ (2017). Impact of health literacy on medication adherence in older people with chronic diseases. Collegian, 24 (1): 11-8.
40. Kinoshita S, Hirooka N, Kusano T, et al (2024). Does health literacy influence health-related lifestyle behaviors among specialists of health management? A cross-sectional study. BMC Prim Care, 25 (1): 29.
41. Liu YB, Liu L, Li YF, Chen YL (2015). Relationship between health literacy, health-related behaviors and health status: A survey of elderly Chinese. Int J Environ Res Public Health, 12 (8): 9714-25.
42. Friis K, Vind BD, Simmons RK, Maindal HT (2016). The Relationship between health literacy and health behaviour in people with diabetes: A Danish population-based study. J Diabetes Res, 2016:7823130.
43. Sarhan MBA, Fujiya R, Kiriya J, et al (2023). Health literacy among adolescents and young adults in the Eastern Mediterranean region: A scoping review. BMJ Open, 13 (6): e072787.
44. Ashida S, Goodman M, Pandya C, et al (2011). Age differences in genetic knowledge, health literacy and causal beliefs for health conditions. Public Health Genomics, 14 (4-5): 307-16.
45. Cheah YK (2013). Determinants of the demand for using preventive medical care among adults in Penang, Malaysia. Malays J Med Sci, 20 (1): 46-55.
46. Liu L, Qian X, Chen Z, He T (2020). Health literacy and its effect on chronic disease prevention: Evidence from China's data. BMC Public Health, 20 (1): 690.
47. Shrestha A, Singh SB, Khanal VK, et al (2018). Health literacy and knowledge of chronic diseases in Nepal. Health Lit Res Pract, 2 (4): e221-e30.
48. Selvakumar D, Sivanandy P, Ingle PV, et al (2023). Relationship between treatment burden, health literacy, and medication adherence in older adults coping with multiple chronic conditions. Medicina (Kaunas), 59 (8):1401.
49. Lee HY, Lee J, Kim NK (2015). Gender differences in health literacy among Korean adults: Do women have a higher level of health literacy than men? Am J Mens Health, 9 (5): 370-9.
50. Amoah PA, Phillips DR (2020). Socio-demographic and behavioral correlates of health literacy: A gender perspective in Ghana. Women Health, 60 (2): 123-139.
51. Sun S, Lu J, Wang Y, et al (2022). Gender differences in factors associated with the health literacy of hospitalized older patients with chronic diseases: A cross-sectional study. Front Public Health, 10 944103.
52. Joshi H, Kalauni BR, Bhusal K, et al (2024). Health literacy among patients with non-communicable diseases at a tertiary level hospital in Nepal: A cross-sectional study. PLoS One, 19 (6): e0304816.
53. Tang C, Wu X, Chen X, et al (2019). Examining income-related inequality in health literacy and health-information seeking among urban population in China. BMC Public Health, 19 (1): 221.
54. Aye T, Aung M, Oo E (2018). Diabetes mellitus in Myanmar: Socio-cultural challenges and strength. Journal of Social Health and Diabetes, 2 (1): 009-13.
55. Joveini H, Rohban A, Askarian P, et al (2019). Health literacy and its associated demographic factors in 18-65-year-old, literate adults in Bardaskan, Iran. J Educ Health Promot, 8: 244.
56. Haeger C, Lech S, Messer M, et al (2023). Urban-rural differences in health literacy in the metropolitan area of Berlin, Germany, and its surroundings. Eur J Public Health, 33 (4): 561-7.
57. Sørensen MLB, Rønfeldt LL, Nørgaard B, et al (2023). Cancer patients’ experience of a patient-safe pathway is asssociated with health literacy and support from relatives: A cross-sectional survey. European Journal of Cancer Care, 2023:1-8.
58. Yang L, Liu J, Liu Q, et al (2023). The relationships among symptom experience, family support, health literacy, and fear of progression in advanced lung cancer patients. J Adv Nurs, 79 (9): 3549-58.
59. Zolfaghari A, Shaker Ardekani S, Mohammadi N, et al (2019). Investigation of the relationship between health literacy and demographic variables of Yazd city citizens. Biquarterly Iranian Journal of Health Psychology, 2 (1):95-102.
60. Kim SH, Utz S (2018). Association of health literacy with health information‐seeking preference in older people: A correlational, descriptive study. Nurs Health Sci, 20 (3): 355-60.
61. Estacio EV, Whittle R, Protheroe J (2019). The digital divide: Examining socio-demographic factors associated with health literacy, access and use of internet to seek health information. J Health Psychol, 24 (12): 1668-75.
62. Jacobs W, Amuta AO, Jeon KC, et al (2017). Health information seeking in the digital age: An analysis of health information seeking behavior among US adults. Cogent Social Sciences, 3 (1).
63. Federman AD, Sano M, Wolf MS, et al (2009). Health literacy and cognitive performance in older adults. J Am Geriatr Soc, 57 (8): 1475-80.
64. O'Conor R, Muellers K, Arvanitis M, et al (2019). Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study. Respir Med, 160: 105630.
65. Levin-Zamir D, Leung AYM, Dodson S, et al (2017). Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective. Stud Health Technol Inform, 240:392-414.
66. Shaw SJ, Huebner C, Armin J, et al (2009). The role of culture in health literacy and chronic disease screening and management. J Immigr Minor Health, 11(6):460-7.
67. Sa’u Lilo L, Tautolo ES, Smith M (2020). Health Literacy, Culture and Pacific Peoples in Aotearoa, New Zealand: A Review. Pacifichealth, 3(3).
2. Centers for Disease Control and Prevention (2019). Understanding health literacy. Place of publication. Available from: https://www.cdc.gov/health-literacy/php/about/understanding.html
3. Peerson A, Saunders M (2009). Health literacy revisited: What do we mean and why does it matter? Health Promot Int, 24 (3): 285-96.
4. World Health Organization (2023). Ninth global conference on health promotion. Available from: https://www.who.int/teams/health-promotion/enhanced-wellbeing/ninth-global-conference
5. Abel T, Apfel F, Böcken J, et al (2013).Health literacy: The solid facts. WHO Regional Office for Europe. Denmark.
6. World Health Organization (2023). Non-communicable diseases. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
7. World Health Organization (2019). Noncommunicable diseases in South-East Asia. Available from: https://www.who.int/southeastasia/health-topics/noncommunicable-diseases
8. Rajah R, Hassali MAA, Murugiah MK (2019). A systematic review of the prevalence of limited health literacy in Southeast Asian countries. Public Health, 167:8-15.
9. Aljassim N, Ostini R (2020). Health literacy in rural and urban populations: A systematic review. Patient Educ Couns, 103 (10): 2142-54.
10. O'Conor R, Moore A, Wolf MS (2020). Health Literacy and its impact on health and healthcare outcomes. Stud Health Technol Inform, 269:3-21.
11. Bruand P-E, Magne J, Guerchet M, Aboyans V, Preux P-M (2023). Health literacy in low and middle income countries. International Journal of Noncommunicable Diseases, 8 (4): 226-32.
12. Joanna Briggs Institute (2020). Critical appraisal tools. Available from: https://jbi.global/critical-appraisal-tools
13. Goplen CM, Verbeek W, Kang SH, et al (2019). Preoperative opioid use is associated with worse patient outcomes after total joint arthroplasty: A systematic review and meta-analysis. BMC Musculoskelet Disord, 20 (1): 234.
14. Khatiwada B, Rajbhandari B, Mistry SK, et al (2022). Prevalence of and factors associated with health literacy among people with non-communicable Diseases (NCDs) in South Asian countries: A systematic review. Clin Epidemiol Glob Health, 18:101174.
15. Cheah YK, Su TT (2012). The determinants of consumer health information on chronic non-communicable disease: An exploratory study in Penang, Malaysia. Journal of the University of Malaya Medical Centre, 15 (2): 1-7.
16. Dinh HTT, Nguyen NT, Bonner A (2020). Health literacy profiles of adults with multiple chronic diseases: A cross‐sectional study using the health literacy questionnaire. Nurs Health Sci, 22 (4): 1153-1160.
17. Piwpong R, Marungsee S, Sungsrikaw T, Jhornlumkone B (2023). A study of health literacy and clinical outcomes of older adults with hypertension and diabetes in Northeastern communities, Thailand. Journal for ReAttach Therapy and Developmental Diversities, 6 (3s): 683-690.
18. Suarilah I, Lin CC (2022). Factors influencing self-management among Indonesian patients with early-stage chronic kidney disease: A cross-sectional study. J Clin Nurs, 31 (5-6): 703-715.
19. Tan WY, Ismail M (2020). Health literacy among adult type 2 diabetes mellitus (T2dm) patients in Kang health district Malaysia. Journal of Health and Translational Medicine, 23:245-253.
20. Medyati N, Amiruddin R, Arsunan A, et al (2019). Health literacy as a risk predictor of cardiovascular diseases among informal sector workers in Makassar city. Indian Journal of Public Health Research & Development, 10 (2).
21. Rahmawati R, Amiruddin R, Zulkifli A, et al (2021). The effect of communicative and critical health literacy on primary stroke prevention behavior of patients with hypertension. Linguistica Antverpiensia.
22. Rachmawati U, Sahar J, Wati DNK (2019). The association of diabetes literacy with self-management among older people with type 2 diabetes mellitus: a cross-sectional study. BMC Nurs, 18 (Suppl 1): 34.
23. Wannasirikul P, Termsirikulchai L, Sujirarat D, et al (2016). Health literacy, medication adherence, and blood pressure level among hypertensive older adults treated at primary health care centers. Southeast Asian J Trop Med Public Health, 47 (1): 109-20.
24. Asharani P, Lau JH, Roystonn K, et al (2021). Health literacy and diabetes knowledge: A nationwide survey in a multi-ethnic population. Int J Environ Res Public Health, 18 (17): 9316.
25. Ong-Artborirak P, Seangpraw K, Boonyathee S, et al (2023). Health literacy, self-efficacy, self-care behaviors, and glycemic control among older adults with type 2 diabetes mellitus: a cross-sectional study in Thai communities. BMC Geriatr, 23 (1): 297.
26. Froze S, Arif MT, Saimon R (2019). Determinants of health literacy and healthy lifestyle against metabolic syndrome among major ethnic groups of Sarawak, Malaysia: A multi-group path analysis. Open Public Health Journal, 12 (1): 172-83.
27. Jaafar N, Perialathan K, Krishnan M, et al (2021). Malaysian health literacy: Scorecard performance from a national survey. Int J Environ Res Public Health, 18 (11): 5813.
28. Sornlorm K, Thi WM (2024). Health literacy and high blood pressure among Myanmar migrant workers in Northeastern Thailand. PLoS One, 19 (4): e0302057.
29. Dai Minh L, Quang BV, Ngoc Le Mai D, et al (2022). Health literacy of newly-admitted cancer patients in Vietnam: Difficulties understanding treatment options and processing health-related information. Health Serv Insights, 15: 11786329211067325.
30. Lai AY, Ishikawa H, Kiuchi T, Mooppil N, Griva K (2013). Communicative and critical health literacy, and self-management behaviors in end-stage renal disease patients with diabetes on hemodialysis. Patient Educ Couns, 91 (2): 221-7.
31. Nutbeam D (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15 (3).
32. Mirczak A (2022). Functional, communicative and critical health literacy among older Polish citizens. Med Pr, 73 (3): 191-199.
33. Das S, Mia MN, Hanifi SM, et al (2017). Health literacy in a community with low levels of education: Findings from Chakaria, a rural area of Bangladesh. BMC Public Health, 17(1):203.
34. Heijmans M, Waverijn G, Rademakers J, et al (2015).Functional, communicative and critical health literacy of chronic disease patients and their importance for self-management. Patient Educ Couns, 98(1):41-48.
35. Shahid R, Shoker M, Chu LM, et al (2022). Impact of low health literacy on patients' health outcomes: A multicenter cohort Study. BMC Health Serv Res, 22 (1): 1148.
36. Cartwright LA, Dumenci L, Cassel JB, et al (2017). Health literacy is an independent predictor of cancer catients' hospitalizations. Health Lit Res Pract, 1 (4): e153-e62.
37. Radhi MM, Balat KZ (2024). Health literacy and its association with medication adherence in patients with hypertension: A mediating role of social support. Iranian Rehabilitation Journal, 22 (1): 117-127.
38. Al-Ali NM, Telfah RK (2023). The effect of health literacy in explaining medication adherence among patients with hypertension: A cross-sectional study of Syrian refugees in Jordan. Int J Nurs Pract, 29 (3): e13136.
39. Lee YM, Yu HY, You MA, Son YJ (2017). Impact of health literacy on medication adherence in older people with chronic diseases. Collegian, 24 (1): 11-8.
40. Kinoshita S, Hirooka N, Kusano T, et al (2024). Does health literacy influence health-related lifestyle behaviors among specialists of health management? A cross-sectional study. BMC Prim Care, 25 (1): 29.
41. Liu YB, Liu L, Li YF, Chen YL (2015). Relationship between health literacy, health-related behaviors and health status: A survey of elderly Chinese. Int J Environ Res Public Health, 12 (8): 9714-25.
42. Friis K, Vind BD, Simmons RK, Maindal HT (2016). The Relationship between health literacy and health behaviour in people with diabetes: A Danish population-based study. J Diabetes Res, 2016:7823130.
43. Sarhan MBA, Fujiya R, Kiriya J, et al (2023). Health literacy among adolescents and young adults in the Eastern Mediterranean region: A scoping review. BMJ Open, 13 (6): e072787.
44. Ashida S, Goodman M, Pandya C, et al (2011). Age differences in genetic knowledge, health literacy and causal beliefs for health conditions. Public Health Genomics, 14 (4-5): 307-16.
45. Cheah YK (2013). Determinants of the demand for using preventive medical care among adults in Penang, Malaysia. Malays J Med Sci, 20 (1): 46-55.
46. Liu L, Qian X, Chen Z, He T (2020). Health literacy and its effect on chronic disease prevention: Evidence from China's data. BMC Public Health, 20 (1): 690.
47. Shrestha A, Singh SB, Khanal VK, et al (2018). Health literacy and knowledge of chronic diseases in Nepal. Health Lit Res Pract, 2 (4): e221-e30.
48. Selvakumar D, Sivanandy P, Ingle PV, et al (2023). Relationship between treatment burden, health literacy, and medication adherence in older adults coping with multiple chronic conditions. Medicina (Kaunas), 59 (8):1401.
49. Lee HY, Lee J, Kim NK (2015). Gender differences in health literacy among Korean adults: Do women have a higher level of health literacy than men? Am J Mens Health, 9 (5): 370-9.
50. Amoah PA, Phillips DR (2020). Socio-demographic and behavioral correlates of health literacy: A gender perspective in Ghana. Women Health, 60 (2): 123-139.
51. Sun S, Lu J, Wang Y, et al (2022). Gender differences in factors associated with the health literacy of hospitalized older patients with chronic diseases: A cross-sectional study. Front Public Health, 10 944103.
52. Joshi H, Kalauni BR, Bhusal K, et al (2024). Health literacy among patients with non-communicable diseases at a tertiary level hospital in Nepal: A cross-sectional study. PLoS One, 19 (6): e0304816.
53. Tang C, Wu X, Chen X, et al (2019). Examining income-related inequality in health literacy and health-information seeking among urban population in China. BMC Public Health, 19 (1): 221.
54. Aye T, Aung M, Oo E (2018). Diabetes mellitus in Myanmar: Socio-cultural challenges and strength. Journal of Social Health and Diabetes, 2 (1): 009-13.
55. Joveini H, Rohban A, Askarian P, et al (2019). Health literacy and its associated demographic factors in 18-65-year-old, literate adults in Bardaskan, Iran. J Educ Health Promot, 8: 244.
56. Haeger C, Lech S, Messer M, et al (2023). Urban-rural differences in health literacy in the metropolitan area of Berlin, Germany, and its surroundings. Eur J Public Health, 33 (4): 561-7.
57. Sørensen MLB, Rønfeldt LL, Nørgaard B, et al (2023). Cancer patients’ experience of a patient-safe pathway is asssociated with health literacy and support from relatives: A cross-sectional survey. European Journal of Cancer Care, 2023:1-8.
58. Yang L, Liu J, Liu Q, et al (2023). The relationships among symptom experience, family support, health literacy, and fear of progression in advanced lung cancer patients. J Adv Nurs, 79 (9): 3549-58.
59. Zolfaghari A, Shaker Ardekani S, Mohammadi N, et al (2019). Investigation of the relationship between health literacy and demographic variables of Yazd city citizens. Biquarterly Iranian Journal of Health Psychology, 2 (1):95-102.
60. Kim SH, Utz S (2018). Association of health literacy with health information‐seeking preference in older people: A correlational, descriptive study. Nurs Health Sci, 20 (3): 355-60.
61. Estacio EV, Whittle R, Protheroe J (2019). The digital divide: Examining socio-demographic factors associated with health literacy, access and use of internet to seek health information. J Health Psychol, 24 (12): 1668-75.
62. Jacobs W, Amuta AO, Jeon KC, et al (2017). Health information seeking in the digital age: An analysis of health information seeking behavior among US adults. Cogent Social Sciences, 3 (1).
63. Federman AD, Sano M, Wolf MS, et al (2009). Health literacy and cognitive performance in older adults. J Am Geriatr Soc, 57 (8): 1475-80.
64. O'Conor R, Muellers K, Arvanitis M, et al (2019). Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study. Respir Med, 160: 105630.
65. Levin-Zamir D, Leung AYM, Dodson S, et al (2017). Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective. Stud Health Technol Inform, 240:392-414.
66. Shaw SJ, Huebner C, Armin J, et al (2009). The role of culture in health literacy and chronic disease screening and management. J Immigr Minor Health, 11(6):460-7.
67. Sa’u Lilo L, Tautolo ES, Smith M (2020). Health Literacy, Culture and Pacific Peoples in Aotearoa, New Zealand: A Review. Pacifichealth, 3(3).
| Files | ||
| Issue | Vol 54 No 10 (2025) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v54i10.20135 | |
| Keywords | ||
| Health literacy Health outcome NCD Health behaviour Socioeconomic status Southeast Asia | ||
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How to Cite
1.
Thu SY, Pranata MA, Yeh Y, Lin F-G. Exploring the Interplay of Health Literacy and Non-Communicable Disease Health Outcomes in Southeast Asia: A Systematic Review. Iran J Public Health. 2025;54(10):2161-2172.
