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Table 3 Interventions prioritised for testing in European settings

From: Healthy ageing in Europe: prioritizing interventions to improve health literacy

Title(s) for each unique project or intervention programme Disease, risk or communication factor Design and outcomes IIMHL strategy Nos. MCS
A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients [33] Hypertension; Comms with HPs 2 arm RCT study design, physician and patient communication skills both improved significantly, but reductions in blood pressure and changes in adherence were negligible 1,2,3,6, 1p, 2p, 3p, 6p 8
Effects of self-management support on structure, process, and outcomes among vulnerable patients with diabetes [37]; Seeing in 3-D: examining the reach of diabetes self-management support strategies in a public health care system [36] Diabetes 3 arm RCT, weekly telephone automated support led to more improvements in self management behaviour (SMB) than individual monthly visits from health educator; both improved in SMB over usual care group, but negligible inter-arm differences in clinical indicators 1, 2, 3, 5 7 8
A patient-centric, provider-assisted diabetes tele health self-management intervention for urban minorities [41] Diabetes 2 arm RCT to test action plan creation with online self-management monitoring, education and group support. Significant improvement in clinical indicators for intervention arm 1, 2, 3, 4 7
Multisite randomized trial of a single-session versus multisession literacy-sensitive self-care intervention for patients with heart failure [34] CVD 2 arm RCT to test literacy-level appropriate education with ongoing telephone support. Those with lower-literacy had reduced although not significantly lower hospitalisations and rate of death 1, 2, 3 7
I’m taking charge of my arthritis”: designing a targeted self-management program for frail seniors” [29] MSD 6 home visits to housebound seniors (no controls) to improve self-management. High satisfaction reported by coaches and majority of patients reported significant improvements in psychological well-being and self-efficacy 1, 2, 3, 4 7
Activ-ins-Alter, Active Ageing [32] Non-specific No controls. Series of home visits by health counsellors to socioeconomically marginalised people, success was measured with respect to increased knowledge and skills as well as increased willingness to engage with public services and find health information 1, 2, 3, 4, 6, 7 6.5
The ‘10 Keys’ to Healthy Aging: 24-month follow-up results from an innovative community-based prevention program [42] Non-specific No controls. Series of home visits by health counsellors to give advice on healthy lifestyle choices, with goal-setting agreed by participants. Resulted in moderate increases in adherence and preventative behaviours 1, 3 6.5
Effectiveness of the chronic disease self-management program for persons with a serious mental illness: a translation study [44] Randomised controlled trial of a lay-led self-management programme for Bangladeshi patients with chronic disease [30] Depression Any chronic illness Both Lorig et al. (no controls) and Griffiths et al. (2 arm RCT) are adaptations of same programme for self-management of chronic disease. Composed of 6–8 group support and education sessions led by qualified peer-leaders (culturally sensitive, leaders have same health condition). Main outcomes are significant improvements in many aspects of self-efficacy and perceived well-being either for cohort after 6 months or for intervention arm over controls 1, 2, 3, 4, 5, 6, 7 6.5 6
Developing and testing lay literature about breast cancer screening for African American women [45]; Delta project: increasing breast cancer screening among rural minority and older women by targeting rural healthcare providers [46] Breast cancer Comparison group but not RCT. Combination of group counselling and raising physician awareness with custom-designed culturally sensitive literature to inform patients about prevention and detection for breast cancer and to help professionals better counsel patients. Mammogram rates in intervention counties were higher than in comparison counties 1, 2, 3, 4, 5, 6, 7, 1p, 2p, 3p 7 5.5
Promoting a breast cancer screening clinic for underserved women: a community collaboration [38] Breast cancer No controls or before/after comparison. Culturally sensitive outreach clinic to underserved minorities to promote sonograms and mammograms. One breast cancer case detected and high satisfaction rates achieved 1, 2, 3, 6, 7 6
Disease management to promote blood pressure control among African Americans [43] Hypertension 2 arm RCT, lifestyle telephone nurse counselling with educational materials vs. BP monitor alone (control). Intervention group had significant improvements in clinical outcomes and frequency of self-monitoring 1, 2, 3, 6, 1p, 2p 6
Impact of a cardiovascular risk control project for South Asians (Khush Dil) on motivation, behaviour, obesity, blood pressure and lipids [31] CVD, diabetes, exercise, nutrition No controls. Small number of targeted culturally sensitive individual counselling sessions with followup and culturally adapted materials. Significant improvement in some lifestyle and diet behaviours 1, 2, 3, 4, 6, 7 6
An advance directive redesigned to meet the literacy level of most adults: a randomized trial [35] Non-specific 2 arm RCT, testing low literacy vs. standard advance care planning forms. The low-literacy form was preferred by participants and had higher completion rates 1, 3, 5, 6 6
Activating community health centre patients in developing question-formulation skills: a qualitative study [39] Comms with HPs No controls. Patients were coached to take an active role and ask assertive questions during medical appointments. Afterwards, most said the preparation was helpful and many noted that they were more actively involved in their appointment than usual 2, 3, 4, 5 4.5
Cancer risk communication with low health literacy patients: a continuing medical education program [40] Comms with HPs Cluster RCT. Physicians received training in better communication with low literacy patients and visits from ‘standardised patients’ to assess performance. Negligible differences in physician communication skills between arms 1, 2, 3, 4, 5, 1p, 2p, 3p, 5p 3.5
  1. p suffix denotes strategies targeted at health professionals (HPs)
  2. MSC multi-criteria score, MSD Musculoskeletal disorders, CVD cardiovascular or ischemic heart disease