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Effect of an mHealth Intervention to Improve Health Literacy in Immigrant Populations

A Quasi-experimental Study

Fernández-Gutiérrez, Martina, PhD, MNursSci; Bas-Sarmiento, Pilar, PhD, MSc; Poza-Méndez, Miriam, PhD, MSc, RN

CIN: Computers, Informatics, Nursing: March 2019 - Volume 37 - Issue 3 - p 142–150
doi: 10.1097/CIN.0000000000000497

Health literacy is a social determinant of the basic health of populations and is especially important to enhancing and developing the empowerment of migrant populations. To evaluate the effectiveness of an mHealth intervention to improve the cognitive and social skills that enable migrants to access and use health services, we developed a quasi-experimental design to encompass a single group of enrolled immigrants (N = 93). They completed preintervention and postintervention questionnaires of the European Health Literacy Survey Questionnaire, the self-created questionnaire HL-APP-Q14 (Health Literacy App Questionnaire), and a practical simulation test. Health literacy improved significantly after the intervention, increasing from a problematic level (mean, 9.55 [SD, 4.35]) to a sufficient level (mean, 14.03 [SD, 2.68]). Differences were statistically significant for males and females as well as for participants of all nationalities, except the Chinese group. The application e_SaludAble empowered the migrant participants through the improvement of their health literacy.

Author Affiliations: Departments of Nursing and Physiotherapy (Drs Fernández-Gutiérrez and Bas-Sarmiento), Faculty of Nursing, University of Cadiz; and Valora Prevention Ltd (Dr Poza-Méndez), Cádiz, Spain.

This article is funded from General Direction of the Coordination of Migratory Policies (Andalusian Government, File No. 2011/10), and it is part of the Nonoriented Fundamental Research Project of the Ministry of Science and Innovation of the Spanish Government (Ref. PSI2011-25554).

This work has been awarded in the Call for Initiatives of Health Literacy of the Andalusian School of Public Health (Escuela Andaluza de Salud Pública, EASP) 2017.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Corresponding author: Martina Fernández-Gutiérrez, PhD, MNursSci, Faculty of Nursing, University of Cadiz, Venus Street, 11207, Algeciras, Cádiz, Spain (

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