Health literacy and self-care among adult immigrants with type 2 diabetes: a scoping review.

Introduction: There exists a gap in the health status of immigrants in comparison to the overall population, and health literacy has been shown to be a mediator for health outcomes and may predict their quality of life (QoL). We aimed to systematically map and synthesize research findings on adult immigrants' health literacy in terms of their health beliefs, understanding, and self-management of Type 2 Diabetes Mellitus.

Methods: A scoping review guided by Arksey and O'Malley's framework was conducted, based on systematic searches in the Embase, Ovid MEDLINE, and APA PsycInfo databases in June 2023. The retrieved articles were screened and assessed by the two authors independently.

Results: Of 568 identified studies, 16 (9 qualitative, 4 cross-sectional, 1 mixed-methods, and 2 experimental) were included in this review. Low/moderate health literacy levels with no sex-related differences were reported. Immigrants' access to health information was limited by language barriers and a lack of culturally adapted information, especially from their physicians. Among women, access to health information was limited by patriarchal norms. Knowledge gaps were primarily related to understanding the necessity of medication and the importance of a healthy lifestyle. Healthcare professionals played an important role in motivating immigrants to adhere to treatment.

Conclusion: Few studies were found on this topic, and additional research is needed to enhance health literacy among immigrants. Limited health information, language barriers, and a shortage of culturally sensitive knowledge appear to hinder immigrants' ability to access, understand, and apply health information. Cultural norms and personal factors further suppress these abilities, ultimately impacting their health outcomes. The findings of this study suggest that health literacy is a crucial component of healthcare professionals' curricula, equipping them with the skills to identify and assist patients with low health literacy.