Guided paths to understanding: can patient navigation improve health literacy among adults in the Philippines?

Abstract

Patient navigation shows promise for improving healthcare access and health information, though its impact on health literacy among underserved populations in developing countries remains underinvestigated. This study evaluated the effectiveness of patient navigation services in improving health literacy in the Philippines. Using a quasi-experimental, one-group pretest-posttest design over 2 months, 105 participants were recruited through random sampling from a tertiary hospital. The intervention provided personalized guidance on healthcare access, health information, appointment scheduling, and referrals. Health literacy was assessed across four dimensions (Access, Understand, Appraise, Apply) using a researcher-developed questionnaire. Participant demographics showed a majority aged 18-30 years (68.6%), female (75.2%), single (63.8%), and college/university educated (53.3%). Nearly half (45.7%) had no income, while 31.4% earned below minimum wage. Participants reported using patient navigation to consult a doctor (75.2%) and were made aware of the available services mostly through other family members (28.6%). Follow-up data revealed significant improvements across all health literacy dimensions (P < .001). In the Access dimension, participants who strongly agreed increased from 18% to 35% in knowing where to find information, and from 16% to 34% in having easy access. The Understand dimension showed gains from 20% to 39% for comprehending provider information, and 21% to 38% for understanding risks and benefits. The Appraise dimension improved from 22% to 36% for evaluating accuracy, and 24% to 39% for asking pertinent questions, while the Apply dimension increased from 25% to 35% for making informed decisions, and 23% to 37% for taking health action. These results suggest that patient navigation services can effectively enhance health literacy among Filipino adults, demonstrating the potential of this patient-centered approach in promoting health equity in similar settings.