A systematic review of the effects of educational interventions on health literacy knowledge and communication techniques among healthcare professionals

Abstract

Abstract Background Low health literacy (HL) undermines patient safety and health outcomes by hindering effective communication. This systematic review aggregated evidence on the impact of educational interventions on healthcare professionals’ (HCPs’) HL competency, specifically examining changes in knowledge, experience, and communication techniques. Methods A systematic search of PubMed, CINAHL (via Hinari) and APA PsycInfo was conducted for studies published between 2010 and 2025. 22 primary studies, including randomized controlled trials and quasi-experimental designs. Following PRISMA guidelines, evidence was synthesized narratively. Risk of bias was assessed using Cochrane ROB-2 and ROBINS-I tools. Results Interventions consistently enhanced HCPs’ HL knowledge and self-reported confidence. Significant improvements were observed in communication techniques, specifically the adoption of teach-back and plain language strategies. However, evidence for sustained behavioral change in clinical practice was inconsistent, with few studies demonstrating long-term skill retention. Most non-randomized studies exhibited serious to critical risk of bias. Furthermore, the reliance on self-reported measures rather than objective behavioral assessments limits the certainty of the findings. Conclusion and recommendations Educational interventions effectively improve cognitive and affective components of HL competence. However, translating these gains into sustained clinical behavior and improved patient outcomes remains uncertain due to methodological limitations. Future research should prioritize longitudinal designs, objective behavioral metrics, and patient-reported outcomes to establish the real-world impact of HL training. High-quality, randomized designs are needed to strengthen the evidence base for clinical education.