Health literacy and integration into healthcare systems for refugees: a scoping review of health educational interventions (Preprint)

BACKGROUND Refugees commonly encounter barriers when accessing and navigating healthcare. While many educational interventions have been implemented to improve health literacy, the evidence is scattered. This emphases the need for a consolidation and synthesis of educational interventions. OBJECTIVE The purpose of this scoping review is to map and critically synthesise healthcare-related educational interventions designed for refugee populations. Specifically, it examines (1) the knowledge themes and topics of the healthcare educational interventions reported, (2) the pedagogical approaches, delivery formats, and educational tools employed and 3) the evaluation strategies and outcomes reported. METHODS A scoping search was conducted in four major databases (PubMed, CINAHL, EMBASE, and ERIC) for studies published between 2018 and 2024 that implemented and assessed a health or health-education intervention for refugee populations using the Joanna Briggs Institute (JBI) approach. RESULTS Forty-two studies satisfied the inclusion criteria. A wide range of health-related themes were identified but Diseases and Conditions, Mental Health, and Nutrition were identified as the most common knowledge themes across the included interventions reflecting refugee needs. Interventions used a variety of delivery methods, such as in-person, online, and mixed formats, although fully online interventions occurred less frequently in the studies explored. Didactic, lecture-style approaches were mainly adopted and applied across many interventions, however interactive and peer-led models were reported in some studies. Different studies varied in how they involved refugees and community members in the design and delivery of educational interventions. Approximately, one-third of the interventions actively included refugees in the design and development of the interventions. Outcomes of the educational interventions explored, were mainly measured in terms of knowledge gain, with fewer studies assessing behavioural change, health outcomes, or long-term impact. Where behavioural and health outcomes were reported, results were mixed. Finally, no relationship between educational approaches and outcomes could be conclusively discerned. CONCLUSIONS Overall, this review provides a practical evidence basis for researchers, policymakers, and practitioners seeking to design and implement educational initiatives that improve health literacy and healthcare integration for refugee populations.