Health literacy in adults with a spinal cord injury or disorder: An updated and expanded systematic review.

Background: The importance of health literacy in personal health management is widely recognised in the general population, yet remains poorly understood in some patient groups, including people with spinal cord injury or disorder (SCI/D).

Objectives: The systematic review had two objectives: (1) to determine the health literacy levels of individuals with SCI/D, and (2) to identify facilitators and barriers to developing health literacy in this group.

Methods: Seven databases (CINAHL, Embase, Emcare, ProQuest, PsycINFO, PubMed, and Web of Science) were searched from inception, with an updated search completed on January 21, 2025. Study quality was evaluated (QualSyst Checklist) and both quantitative and qualitative research narratively summarised by our research aims.

Results: Seven quantitative studies and one qualitative study (N = 2471 participants) published from 2005 to 2022 were included. All demonstrated good methodological rigour. Most participants reported having sufficient health literacy. Those with higher health literacy were more likely to have higher education and socio-economic advantage, and to experience better physical and mental health outcomes. Evidence regarding the role of SCI/D variables in developing health literacy capacity was limited.

Conclusions: Health literacy remains an under-researched topic in the SCI/D literature. Further studies are needed to examine how health literacy can impact health behaviours and overall health for this group. This research would also benefit from focusing on personal experiences of health literacy development.