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Flowchart of the screening process [53]
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Background
Organizational health literacy (OHL) aims to respond to the health literacy needs of patients by improving health information and services and making them easier to understand, access, and apply. This scoping review primarily maps criteria characterizing health literate health care organizations. Secondary outcomes are the concepts and t...
Citations
... Existing literature provides several guides and frameworks for implementing and promoting organizational health literacy. These vary in terms of the number of responsiveness areas they include (Bremer et al., 2021;Farmanova et al., 2018;Trezona et al., 2017). We used the organizational health literacy responsiveness (Org. ...
... It also includes a broad spectrum of organizational health literacy responsiveness areas at different levels of the health organization, from the external policy level, to leadership, community, citizens, and the health workforce level (Trezona et al., 2017). Despite existing guidelines for implementing organizational health literacy (Bremer et al., 2021;Farmanova et al., 2018), only a few studies have explored (i) organizational health literacy responsiveness in maternity care and (ii) how the organization of maternity care inhibits or promotes health professionals' abilities to support the different health literacy needs of pregnant women (Creedy et al., 2021;Hedelund Lausen et al., 2018;Hughson et al., 2018). However, these studies were performed in different settings and more knowledge is needed about strengths and barriers for responsiveness in the organization of maternity care services. ...
... Organizational health literacy assessments are not as widely available; however, this landscape is changing. 12 Two commonly used tools to assess personal health literacy are the Short Assessment of Health Literacy (SAHL) and the Rapid Assessment of Health Literacy in Adult Medicine-Short Form (REALM-SF). These brief assessments measure print and oral health literacy, respectively, and identify patients at risk for low health literacy. ...
Health literacy, or the ability to find, understand, and use information to make well-informed health decisions, has been linked to post-stroke rehabilitation outcomes. Importantly, barriers to health literacy stem from stroke survivor characteristics, clinician practices, institutional norms, as well as systemic variables. These barriers impact recovery and rehabilitation outcomes. To address these obstacles, clinicians can learn from the evidence-based practices used by speech-language pathologists in their work with stroke survivors with aphasia, a language impairment that can follow stroke. These methods to overcome communication barriers are appropriate and recommended for patients and family members regardless of stroke impairment, and include a transdisciplinary care model, multimodal approaches to patient education, along with consistent engagement with patients and their care partners. These strategies may be adopted for both personal and organizational health literacy efforts and help optimize the rehabilitation and recovery outcomes of stroke survivors with and without aphasia.
... There are different ways of defining and measuring OHL (Bremer et al., 2021;Hayran & Ege, 2023). Similar to the assessments of individual health literacy, measures of OHL are varied and there is no one commonly utilized tool. ...
Background
The definition of health literacy has recently expanded beyond the idea of individual skills to include the system and environment the individual interacts with to receive care, known as organizational health literacy (OHL). However, neither the prevalence of OHL nor the impact of OHL on individuals' perceptions of their health and healthcare have been examined in New York's Medicaid managed care population.
Objective
This study aimed to estimate the prevalence of organizational health literacy in the New York State (NYS) Medicaid Managed Care (MMC) program.
Methods
A brief measure to assess organizational health literacy was developed from responses to two questions in the 2018 NYS Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Generalized Estimating Equation models were developed to analyze the association between organizational health literacy and three aspects of perceptions of health and health care, controlling for demographic differences and clustering effects from health insurance plans. Missing data were handled using multiple imputation.
Key Results
Among 3,598 members included in the study, 20% of the MMC members reported inadequate organizational health literacy. These members were more likely to be older, less educated, from racial and ethnic minority groups, and less fluent with English. They are more likely to have poorer self-reported health (odds ratio [OR] 1.49), lower perceived access to health care (OR 6.97), and lower satisfaction with their health care (OR 6.49) than members who did not report inadequate organizational health literacy.
Conclusions
Our results suggest that a proportion of the NYS MMC population faces inadequate organizational health literacy, which can present a barrier to health care access and result in patients having a significantly poorer health care experience. Using an existing data source that is part of existing data collection allows for routine assessment of organizational health literacy, which can help inform health plans about areas for potential improvement. [ HLRP: Health Literacy Research and Practice . 2023;7(3):e154–e164. ]
... Patient-reported measures are arguably one of the best ways to assess constructs that relate to patient-centeredness and evaluate the service quality in healthcare. However, Bremer et al. (71) summarized 13 HLE-related measurement tools in English, and only three of them evaluated HLE from a single patient perspective. Second, most of the strategies for health literacy promotion in China focused on individual competencies where health education is the most common method (30,72,73). ...
... However, improving health literacy is not just addressed by individual skills and abilities, it also depends on the complexities of the healthcare system (5,17). This study provides a new perspective on improving health literacy in China, that is, healthcare organizations make it easier for patients to access, understand, and use health information and service, and provides a tool that has good reliability and validity for evaluating the role played by healthcare organizations in health literacy promotion (71). current research about HLE is mainly from developed countries such as the United States, Germany, and Australia, while our study provides research findings from developing countries. ...
Introduction
While the research on improving individual health literacy by promoting individual skills and abilities is increasing, less attention has been paid to the complexities of the healthcare environment that may influence patients’ ability to access, understand, and apply health information and health services to make health decisions. This study aimed to develop and validate a Health Literacy Environment Scale (HLES) that is suitable for Chinese culture.
Methods
This study was conducted in two phases. First, using the Person-Centered Care (PCC) framework as a theoretical framework, initial items were developed by using the existing health literacy environment (HLE) related measurement tools, literature review, qualitative interviews, and the researcher’s clinical experience. Second, scale development was based on two rounds of Delphi expert consultation and a pre-test conducted with 20 hospitalized patients. Using 697 hospitalized patients from three sample hospitals, the initial scale was developed after item screening and its reliability and validity were evaluated.
Results
The HLES comprised 30 items classified into three dimensions as follows: interpersonal (11 items), clinical (9 items), and structural (10 items) dimensions. The Cronbach’s α coefficient of the HLES was 0.960 and the intra-class correlation coefficient was 0.844. The confirmatory factor analysis verified the three-factor model after allowing for the correlation of five pairs of error terms. The goodness-of-fit indices signified a good fit for the model ( χ ² /df = 2.766, RMSEA = 0.069, RMR = 0.053, CFI = 0.902, IFI = 0.903, TLI = 0.893, GFI = 0.826, PNFI = 0.781, PCFI = 0.823, PGFI = 0.705). The item-content validity index ranged from 0.91 to 1.00, and the scale-content validity index was 0.90.
Conclusion
The HLES had good reliability and validity and provides a patient perspective tool for evaluating HLE and a new perspective for improving health literacy in China. That is, healthcare organizations make it easier for patients to access, understand, and use health information and service. Further studies about the validity and reliability of HLE should include other districts and different tiers or types of healthcare organizations.
... Since then, several reviews have focused on effective strategies for creating health literate organisations, providing insight into implementation barriers and enablers [18][19][20][21][22]. Based on their review, Charoghchian Khorasani and colleagues concluded that shifting to a health literate organisation requires radical, concurrent and multiple changes, because integration is complex and health literacy is rarely integrated into healthcare organisations' vision and strategic planning [20]. ...
Improving organisational health literacy ensures people can navigate, understand and use essential health information and services. However, systematic reviews have identified limited evidence for practical approaches to implementing such organisational change, particularly at a national level. This study aimed to (a) investigate the approach taken by an Australian national diabetes organisation—Diabetes Australia, as the administrator of the National Diabetes Services Scheme (NDSS)—to improve organisational health literacy over a 15-year-period and (b) examine the impact of organisational changes on the health literacy demands of health information. We performed an environmental scan, examining the websites of the NDSS, Diabetes Australia and the Australian government for reports and position statements describing organisational health literacy policies and practices between 2006 and 2021. The Patient Education Materials Assessment Tool (PEMAT) was applied to consecutively published NDSS diabetes self-care fact sheets (n = 20) to assess changes in the health literacy demands (understandability and actionability) of these fact sheets over the same period. We identified nine policies resulting in 24 health literacy practice changes or projects between 2006 and 2021, applied using a streamlined incremental approach and group reflexivity. The incremental approach focused on (1) increasing audience reach, (2) consistency and branding, (3) person-centred language and (4) the understandability and actionability of health information. The PEMAT scores of fact sheets improved between 2006 and 2021 for understandability (53% to 79%) and actionability (43% to 82%). Diabetes Australia’s information development process leveraging national policies, employing an incremental approach and group reflexivity has improved the health literacy demands of diabetes information and serves as a template for other organisations seeking to improve their organisational health literacy.
... Environmental health literacy per se is a relatively new framework to conceptualize "how people understand and use information about potentially harmful environmental exposures and their influence over health" (4). Organizational health literacy, which comprises six main categories (25 subcategories), aims to respond to the HL needs of patients by improving health information and services and making them easier to understand, access, and apply (5). ...
... Registries [30]. The English version of the items that form the self-assessment tool can be found in Additional le 1. Please note that the English version has not been tested yet and might be subject to later rephrasing since the original research was conducted in German. ...
Background: Until now a comprehensive, consensus-based tool that can be used by a variety of health care organizations for assessing their organizational health literacy (OHL) is missing. Therefore, we aimed to develop and test a literature- and consensus-based self-assessment tool.
Methods: The study is based on a literature review that was previously published by the authors. For the development of the self-assessment tool, the criteria identified in the literature were synthesized with criteria gained through group discussions with representatives of different types of health care organizations all based in Hamburg (Germany). Consensus on the criteria was reached through a Delphi process. A review by the project’s persons with lived experience committee was included in the process. The self-assessment tool was converted into an online tool and refined through a pretest. Finally, the online survey was piloted and the reliability and item loadings for each scale were analyzed.
Results: In total, 77 criteria (items) characterizing a health literate health care organization were developed and grouped into five main categories (scales): 1) “easy access and navigation”, 2) “integration, prioritization, and dissemination of OHL”, 3) “qualification, quality management, evaluation, and needs assessment”, 4) “communication with target groups”, and 5) “involvement and support of target groups”. The results of the online survey showed that the tool is suitable for assessing an organization’s status quo on OHL. The psychometric analysis showed good to excellent internal consistency. Item analyses supported the developed self-assessment tool structure.
Conclusions: We were able to define a set of 77 items to characterize OHL. These can be used as a new, comprehensive, and consensus-based self-assessment tool to identify aspects that need improvement. We found evidence that the self-assessment tool, based on the identified criteria, consists of the assumed five scales. Further research should analyze the validity of the self-assessment tool on a higher detail level.
... Therefore, for a concise description, we looked at the review of Sørensen et al. [3], which noted that "a shared characteristic of these definitions is their focus on individual skills to obtain, process and understand health information and services necessary to make appropriate health decisions." Using these common actions as defining criteria, we have concluded that a health-literate health care organization is one that enables its care workers-and, through them, its clients-to find, understand, and use health information and services [4,5]. In contrast, health literacy is the degree to which individuals are able to find, understand, assess and apply health-related information [3]. ...
Organizational health literacy (OHL) is crucial for public health, in turn health care organizations play vital roles in improving populations’ health literacy. Therefore, the aim of this qualitative study was to explore how the organizational health literacy self-assessment tool (OHL Self-AsseT) was implemented, used, and understood by primary care teams from a network of general practices and a Home Care Service Organization in Zurich, Switzerland. Reflexive thematic analysis with a constructivist orientation was used to analyze data from 19 interviews pre- and post-OHL Self-AsseT use. Normalization Process Theory supported structuring of inductively developed themes. Findings show that the participants experienced working with the OHL Self-AsseT meaningful, as it helped with “Addressing OHL construction sites” so that they could “build momentum for change”. The experience of “Succeeding together in construction” led to a “feeling of team-efficacy during change”. Practical use of the tool and/or discussions about OHL led to a growing conceptual understanding, which was described as “Using a construction plan–making sense of ongoing OHL activities”. To conclude, the OHL Self-AsseT encouraged teams to initiate change, led to greater team-efficacy and supported the construction of OHL. Improved implementation strategies will support this intervention’s scale-up as a base for effectiveness testing.
... A equidade deve ser incluída como um imperativo de uma Organização Letrada em Saúde (OLS), incentivando, assim, uma abordagem sistemática para melhorar o LS 2 . Alguns termos correlatos para OLS são encontrados na literatura, como "letramento em saúde organizacional", "organização de cuidado à saúde letrada em saúde" e "responsividade ao letramento em saúde organizacional" 4,5,6 . Nesse estudo foi adotado o termo Organização Letrada em Saúde. ...
Objetivos: analisar as Organizações Letradas em Saúde quanto ao seu conceito, atributos, barreiras e facilitadores para sua implementação, bem como avaliar sua implementação sob uma perspectiva coletiva. Método: foi realizada uma revisão narrativa. A busca bibliográfica foi feita na base de dados PubMed, em julho de 2022, com as palavras-chave: Organization e Health literacy, sendo complementada com outras publicações que abordavam o tema e não foram identificadas nas buscas. A seleção e análise das publicações foram conduzidas em quatro etapas. Resultados: foram consideradas 312 publicações, sendo que 75 estudos foram lidos na íntegra e 20 estudos foram incluídos e analisados. Conclusões: Dez atributos regem as Organizações Letradas em Saúde. A baixa conscientização sobre letramento em saúde é uma importante barreira para a implementação das Organizações Letradas em Saúde, enquanto a melhora da qualidade dos cuidados em saúde e a redução dos custos associados são facilitadores desse processo. Para a implementação das Organizações Letradas em Saúde sob uma perspectiva coletiva, é necessária a participação conjunta dos profissionais de saúde e de toda a comunidade. Por fim, a escassez de estudos sobre a temática apresentada aponta para a necessidade de mais pesquisas, a fim de impulsionar mudanças organizacionais ligadas ao letramento em saúde.
... A equidade deve ser incluída como um imperativo de uma Organização Letrada em Saúde (OLS), incentivando, assim, uma abordagem sistemática para melhorar o LS 2 . Alguns termos correlatos para OLS são encontrados na literatura, como "letramento em saúde organizacional", "organização de cuidado à saúde letrada em saúde" e "responsividade ao letramento em saúde organizacional" 4,5,6 . Nesse estudo foi adotado o termo Organização Letrada em Saúde. ...
Objetivo: Analisar as evidências científicas, visando identificar se o letramento em saúde éimportante no processo de obtenção do consentimento informado em pesquisas científicas.Método: Trata-se de revisão narrativa da literatura, com análise descritiva dos dados. Olevantamento bibliográfico foi realizado, em julho de 2022, na base de dados PubMed, por meioda estratégia de busca “Health Literacy” AND “Informed Consent”. Foram consideradas publicações dos últimos 10 anos nos idiomas inglês, espanhol e português. Foram consideradaspublicações dos últimos 10 anos nos idiomas inglês, espanhol e português. Resultados: Foramrecuperadas 676 publicações e dessas, após três etapas de seleção, foram incluídos seis estudos,publicados em inglês, em periódicos internacionais, com predomínio de estudos de intervenção.Os seis estudos incluídos foram publicados em revistas internacionais, no idioma inglês, entreos anos de 2013 e 2018. Quanto ao delineamento do estudo, predominaram os de intervenção,seguidos pelos observacionais. Todas as publicações abordavam intervenções que consideramo letramento no consentimento informado. Considerações Finais: As evidências científicasapontam para a importância do letramento em saúde no favorecimento da compreensão dopotencial participante sobre a pesquisa, bem como sobre os procedimentos a ela inerentes.Enfim, sugere-se que o letramento em saúde corrobora no processo de obtenção de umconsentimento informado crítico e consciente na pesquisa científica.
