The role of health literacy in vaccination behaviours: a systematic review
Bibliographic record
Abstract
Abstract Background Health literacy (HL) is recognized as a driver of health-promoting behaviors, including preventive actions. However the influence of HL on vaccines uptake remains unclear. This study aimed at summarize the evidence on the role of HL in vaccination behaviors. Methods PubMed, Scopus, and Web of Science were searched. Observational studies of any design conducted worldwide, published through June 2021 and investigated the association between HL and vaccination intention or status using HL validated tools were included. Any vaccine was considered. An adapted Newcastle-Ottawa Scale was used to assess quality. Results Twenty-one articles were included, 6 investigated intention to vaccinate and 15 explored vaccination status. Studies of the first group had a cross-sectional design, considered anti-COVID-19 vaccination and were judged of high or fair quality. Population investigated was heterogeneous as well as the tool used to assess HL. Five analysis provided adjusted estimates. HL seemed not influence the vaccination intention in 3 studies whereas adequate HL was associated with positive attitude to get vaccinated in the remained 3 ones. The majority of articles assessed vaccine status, had a cross sectional design (N = 11) and were of high quality (N = 8). The HL tool more frequently used was TOFHLA (N = 5), sample investigated was heterogeneous included parents of children who received vaccinations (N = 5). Four articles considered multiple vaccinations, thus providing a total of 19 analysis. Vaccine against influenza was the most investigated (N = 11) and 15 studies provided adjusted estimates. No association was found between HL and the receipt of vaccination in 11 analysis, whereas HL levels significantly influenced vaccination uptake in 8 studies. Conclusions Health literacy did not seem to strongly influence people decision on vaccinations. Difference in population and vaccines considered, but also in tool used to measure HL might explain the heterogeneity of the results. Key messages • The impact of HL on vaccination behaviours remains controversial. • Efforts to extend the studies on targeted populations applying a comprehensive HL measurement tool should be devised.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.053 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.009 |
| Bibliometrics | 0.010 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".