44 Study Characteristics Study Results Study CKD-pop(N) Country Design Measure (% LHL) Q Mechanism(s) Association of health literacy with mediator within this mechanism(s) or other result related to mechanism Association of health literacy or mediator with health outcome? Kazley et al., 2015(36) 5 (92) USA Crosssectional REALM1 NVS1 (n.a.) +/- Utilization of care Social context Yes: LHL with lower likelihood of being waitlisted for transplantation and lower social support Yes: LHL with worse transplant outcomes. Yuanhong Lai et al., 2013(52) 5(D) (63) Singapore Crosssectional FCCHL1,2,3 (n.a.) +/- Self-care management Utilization of care Yes: LHL with worse blood glucose testing and foot care. Limited communicative and critical with worse diabetes selfmanagement. Limited communicative HL with less exercise. Limited critical HL associated with worse general diet. No: LHL with duration of Diabetes treatment No: LHL with blood glucose levels Gordon et al., 2009(51) 5(T) (124) USA Crosssectional sTOFHLA1 (9%) REALM1 +/- Self-care management Utilization of care Yes: LHL with shorter time after transplant. In open questions: patients express the need to improve understanding of transplantation and medication use. Yes: LHL with higher serum creatinine levels Wright Nunes et al., 2011(41) 1-4 (399) USA Crosssectional REALM1 (n.a.) +/- Self-care management P-P interaction Yes: LHL with lower perceived kidney disease specific knowledge No: LHL with satisfaction with the provider Yes: Lower knowledge with lower eGFR awareness of CKD Zhong et al., 2019(49) 1-5 (61) USA Crosssectional REALM1 (40.7%) - Self-care management Utilization of care P-P interaction Yes: LHL with medication and lifestyle behaviors, lower health care transition readiness from pediatric care to adult care services (a.o. ability to visit doctors and make appointments), less seeking of information and asking questions in a group of 18-29 years adolescents. Communication with providers positively influences knowledge. Greater nutrition knowledge predicted health care transition readiness No results reported on health outcomes. Photaros et al. 2018(45) 2-4 (275) Thailand Crosssectional HLS-141,2,3 - Self-care management Social context Yes: LHL influences self-efficacy in and performance of lifestyle activities. Self-efficacy is not a mediator of association between LHL and self-management. No: LHL has no direct or indirect effect on social support or family functioning No results reported on health outcomes. Dodson et al. 2016(61) 5(D) (913) Australia Crosssectional HL-Quest.1,2,3 (n.a.) - Self-care management Utilization of care P-P interaction Social context Other: Multifaceted HL screener indicates: compared to a control group of other chronic patients, actively managing health is a greater HL challenge for dialysis patients, while they are better in navigating the health system, engaging with providers, understanding and applying information, and enabling social support. Yes: LHL with worse serum albumin, depressive and anxiety symptoms, and disease and mental burden. Patzer et al., 2016(54) 5(T) (99) USA Mixedmethod REALM1 (24.7%) - Self-care management Utilization of care Yes: LHL with lower medication knowledge and self-reported treatment adherence. No: LHL with demonstrated proper use of medications and hospitalization. No: LHL with graft rejection.
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