Effectiveness of health literacy interventions on the knowledge, skills, and attitudes in community health workers: a systematic review protocol.

Abstract

Objective: This systematic review aims to evaluate the effectiveness of health literacy interventions compared to standard or usual educational practices on the knowledge, skills, and attitudes in community health workers.

Introduction: Health literacy plays a crucial role in improving personal and societal health outcomes. Community health workers, who serve as cultural mediators and health educators in communities, often face gaps in formal training on health literacy. Addressing this need through evidence-based interventions is essential to enhance their competencies and support their critical roles in health care systems worldwide.

Inclusion criteria: The review will consider experimental and quasi-experimental studies, including randomized controlled trials, cohort studies, and cross-sectional studies. Studies evaluating health literacy interventions, such as training, workshops, or seminars, delivered through any modality and language will be included. Primary outcomes include community health workers' health literacy knowledge assessed through validated measures. Secondary outcomes include skills in obtaining and processing health information and health literacy attitudes.

Methods: Databases including PubMed, Embase, and CINAHL will be searched, along with gray literature sources such as ClinicalTrials.gov. Screening of reports and assessment of methodological quality will be done by at least 2 independent reviewers. Data synthesis will involve meta-analysis, where appropriate, with subgroup analyses based on socioeconomic status, intervention duration, and delivery modality. Alternative synthesis methods will be used if statistical pooling is not possible. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to assess the certainty of findings.

Review registration: PROSPERO ID CRD42025639226.