The Effectiveness of Self-Management Interventions for Individuals with Low Health Literacy and/or Low Income: A Descriptive Systematic Review
Open accessAbstract
Background With the burden of chronic illness increasing globally, self-management is a crucial strategy in reducing healthcare costs and increasing patient quality of life. Low income and low health literacy are both associated with poorer health outcomes and higher rates of chronic disease. Thus, self-management represents an important healthcare strategy for these populations. The purpose of this study is to review self-management interventions in populations with low income or low health literacy and synthesize the efficacy of these interventions.Methods A systematic review of trials evaluating the efficacy of self-management interventions in populations with low income or low health literacy diagnosed with a chronic illness was conducted. Electronic databases were primarily searched to identify eligible studies. Data were extracted and efficacy summarized by self-management skills, outcomes, and content tailoring.Results 23 studies were reviewed, with ten reporting an overall positive effect on at least one primary outcome. Effective interventions most often included problem-solving as well as taking action and/or resource utilization. A wide range of health-related outcomes were considered, were efficacious empowerment and disease-specific quality of life were found to be significant. The efficacy of interventions did not seem to vary by duration, format, or mode of delivery or whether these included individuals with low health literacy and/or low income. Tailoring did not seem to impact on efficacy.Discussion Findings suggest that self-management interventions in populations with low income or low health literacy are most effective when three to four self-management skills are utilized, particularly when problem-solving is targeted. Healthcare providers and researchers can use these findings to develop education strategies and tools for populations with low income or low health literacy to improve chronic illness self-management.
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There is increasing evidence that not all self-management skills are equally efficacious.
“However, there is increasing evidence that not all self-management skills are equally efficacious.”
A systematic review by Schaffler et al. suggested that self-management interventions were more efficacious when these included problem-solving, taking action, and resource utilization.
“For instance, a systematic review by Schaffler et al. 73 suggested that self-management interventions were more efficacious when these included problem-solving, taking action, and resource utilization.”
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- Authors
- Schaffler, J., Leung, K., Tremblay, S., Merdsoy, L., Belzile, E., Lambrou, A., & Lambert, S. D.
- Affiliations
- McGill University (CA)
- St Mary's Hospital Centre (CA)
- Corresponding author
- Lambert, Sylvie D.
- Venue
- Journal of General Internal Medicine
- Published
- 2018-02-09
- Volume
- 33
- Issue
- 4
- Pages
- 510-523
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC5880764
- OpenAlex
- W2785318873
- Cited by
- 97
- References
- 74
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 12 · 2023: 18 · 2022: 11 · 2021: 17 · 2020: 11 · 2019: 12 · 2018: 2
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Houston Advanced Research Center
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- self-management interventions, low health literacy, low income, chronic disease, intervention efficacy, problem-solving skills, empowerment, quality of life, health education
- MeSH terms
- Self-Management, Clinical Trials as Topic, Humans, Poverty, Self Care, Treatment Outcome, Health Literacy
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