Interventions used to support individual health literacy related to cardiovascular health in children – a scoping review

Background Recent studies indicate that risk factors for cardiovascular disease (CVD) begin to develop in childhood. Interventions that support the development of health literacy related to cardiovascular health (CVH) in childhood may be beneficial for improving cardiovascular risk factors in young people, however it is unclear whether such interventions exist.Aim To conduct a scoping review to identify all previous interventions that have combined health literacy (or related constructs) and CVH metrics in childhood settings.Methods Two reviewers systematically searched four databases: Medline, Scopus, CINAHL and Web of Science from inception to October 21, 2024. Studies were analysed following the Joanna Briggs Institute (JBI) framework for scoping reviews. Health literacy was defined based on Nutbeam’s health literacy framework. Related constructs included health promotion, health education and health knowledge among others. CVH metrics were defined based on the American Heart Association’s Life’s Essential 8 and included diet, physical activity, body mass index, blood pressure, cholesterol, glucose, smoking and sleep. Studies were included if they considered health literacy or related constructs and at least three CVH metrics.Results We reviewed 5,453 published papers written in English. These papers included empirical studies (original research) and intervention studies. They also covered quantitative studies such as cross-sectional, longitudinal, protocol, cohort, and case-control studies. From these, we identified 46 studies for inclusion in the review, of which 6 were protocols. The largest number of studies were conducted in the US (n = 13); the intervention length ranged from 5 weeks to 4 years and were conducted between 2007 and 2022. Only one intervention explicitly considered health literacy. This 6-week Canadian study, conducted with 126 children aged 9-14 years, measured digital health literacy using a validated questionnaire and CVH metrics (diet, physical activity and sleep). Forty-five other studies used constructs related to health literacy, including health promotion (n = 11), health education (n = 10) and health knowledge and behaviour (n = 8), among others.Conclusion This review identified one intervention that comprehensively measured health literacy and CVH in children. More work is required to understand whether interventions which combine health literacy (or related constructs) and CVH metrics in childhood settings may improve CVH.