Barriers and Facilitators to Implementing Health Literacy Practices in a Pediatric ENT Clinic: A Mixed-Methods Study.

Abstract

Despite strong evidence of improved patient outcomes, clinicians have been slow to adopt health literacy practices. To identify facilitators and barriers to implementing health literacy practices into clinical care. Stakeholders (N = 40) completed surveys of acceptability, appropriateness, feasibility, conviction, and confidence with teach-back practices. Using the Consolidated Framework for Implementation Research (CFIR), interviews (n = 12) were conducted and analyzed. Most reported high acceptability, appropriateness, and feasibility, but low confidence in using teach-back. Facilitators included leadership engagement and relative advantage. Barriers were related to compatibility due to time and workflow constraints. The CFIR-ERIC (Expert Recommendations for Implementing Change) Implementation Strategy Matching Tool was applied to select implementation strategies. The CFIR framework along with the CFIR-ERIC Matching Strategy Tool helped the research team select strategies likely to yield successful implementation and sustained use of health literacy practices.