Organizational Health Research Articles

The M-POHL Health Literacy Population Survey 2024-2026 (HLS24)

Abstract Background Inspired by the first European Health Literacy Survey (HLS-EU) and its policy impact, the WHO Action Network on Measuring Population and Organizational Health Literacy (M-POHL) was established in 2018 under the auspices of WHO Europe to monitor and strengthen health literacy (HL) in Europe. The Health Literacy Survey 2019-2021 (HLS19) was the first project of M-POHL, focusing on both general and specific aspects of HL. The follow-up survey (HLS24) builds on this work and will provide even more comprehensive data on HL by including more countries and new aspects of HL. By also focusing on NCDs and prevention, HLS24 is a key partner in the European Joint Action PreventNCD. Methods The HLS24 is a cross-sectional study based on nationally representative samples of the adult population (18+) in more than 20 participating countries. The HLS24 core questionnaire includes items on general HL, sociodemographics, health behavior, health status, and health care utilization. Some countries also include questions on prevention and early detection of chronic diseases and health problems. Five optional packages (OPs) enable countries to focus on specific aspects of HL, namely digital, communicative, navigational, vaccination and mental HL. Results HLS24 uses a harmonized set of HL instruments that provide a solid database for health policy decisions to strengthen HL and health equity in Europe. In addition to the three OPs on digital, communicative and navigational HL discussed in the following presentations, an 11-item set on vaccination literacy and a 21-item set on mental HL are provided. Conclusions Covering NCDs, prevention, digital health, immunization, and mental health, the HLS24 provides important data on current health challenges and highlights the needs of the European population regarding health information and services upon which policy and action interventions can be based.

Health literacy and access to health services: insights from a national survey in Italy

Abstract Background Health Literacy (HL) entails accessing, understanding, evaluating, and applying healthcare (HC) information. Aim of this study is to assess HL association with HC services use in the Italian adult population. Methods A national survey was conducted in Italy in 2021, in the framework of the WHO network Measuring Population and Organizational Health Literacy (M-POHL). A validated questionnaire was administered to a representative sample of the Italian resident population aged 18+ years (N = 3,500). A 4-point Likert scale was used for answers: very easy, easy, difficult, very difficult. The HL index, as the percentage of very easy/easy responses, was categorized as Inadequate (0-50%), Problematic (51-66%), Sufficient (67-80%), Excellent (81-100%). Inadequate/Problematic were combined in ‘Limiting’ and Sufficient/Excellent in ‘Not limiting’ categories. A multivariate logistic regression analysis, adjusted by sex, age, geographical area, education, and financial deprivation, was used to explore the associations between HL and the frequency, of utilization of general practitioners-GPs (never, once/twice, three/more times), medical or surgical specialist services-MSS (never, once, twice/more), inpatient hospital services-IHS (never, once/more), day-patient hospital services-DPS (never, once/more), taking sick days at work-SD (never, once/twice, three/more) in the last 12 months, and emergency services-ES (never, once/more) in the last 24 months. Results In Limiting HL (64.6%), the prevalence of never using ES is significantly lower compared to Not limiting HL (81.83% vs 83.80%); likewise for never using MSS (45.84% vs 51.24%) and never using DPS (90.87% vs 93.80%). Significant association with Limiting HL was found for using MSS once (Odds Ratio-OR=1.55), twice/more (OR = 1.76) and taking SD once/twice (OR = 1.58). Conclusions Results demonstrate that people using HC services more frequently, in particular MSS and taking SD, require dedicated support to improve HL. Key messages • This study aims to evaluate the association of the individual Health literacy level with the use of several healthcare services in the Italian adult population. • ‘Limiting’ Health Literacy is associated with using medical or surgical specialist services twice or more times and taking sick days at work once or twice.

A guide for policy and decision makers on health literacy policies

Abstract Supported by supranational organizations such as the WHO or the European Union, governments across the world have begun to work systematically on developing and implementing action plans, strategies and policies to improve the health literacy of their citizens and the health literacy friendliness/responsiveness of health organizations. In 2023, a first project on evidence-based policies and practices was initiated by the WHO Action Network on Measuring Population and Organizational Health Literacy (M-POHL) and financially supported by the Swiss Ministry of Health. In this project a guide on how health literacy policies can be developed and implemented was developed by an international working group. This guide brings together insights from existing literature on national health literacy strategies, action plans and interventions, including an expert snowball search within the M-POHL network and among other partners, experiences and case examples collected from M-POHL members and other countries. Feedback on the guide was collected in interactive webinars with policy representatives and decision-makers and addressed. The structure of the guide follows an adapted version of the Public Health Action Cycle model, assisting step-by-step action on health literacy policy development: situation analysis; agenda setting; developing policies, strategies and interventions; implementation; evaluation and monitoring. Each phase is described, and best practices and recommendations provided. The guide closes with a checklist for self-assessment which follows the structure of this document. It supports reflection on the state of policies in a country. This innovative guide contributes to supporting evidence-informed policies and practice. This can be of interest to experts and practitioners who have data on challenges relating to the health literacy levels of population groups and who wish to develop or adjust their policies, services and communications accordingly.

Implementation of organizational health literacy depending on school characteristics in Germany

Abstract Background Children and adolescents are important target groups for health promotion measures to sustain a healthy upbringing. Organizational health literacy in schools is a promising environmental intervention to strengthen health literacy in school children. This study examines the relationship between school characteristics and the implementation of organizational health literacy. Methods School principals in Germany were invited to complete a 20-minute online survey between November 2022 and July 2023. An 8-item self-report tool was used to measure organizational health literacy in schools (OHLS-Q-SF) that comprehends eight different areas within schools to become health literate. A hierarchical cluster analysis was carried out to identify groups according to the composition of the socioeconomic status of the student body. Descriptive statistics, Mann-Whitney-U tests, and Kruskal-Wallis tests were performed. Results 598 school principals (73.6% female, Ø 52.3 years old) who worked at primary schools (49.1%), secondary schools (37%), and special education schools (13.9%) completed the survey. Cluster analysis revealed two groups. The first one (36.8%) contains schools with mainly students with lower socioeconomic status, and the second group (63.2%) contains schools with more students from middle or higher socioeconomic status. The socioeconomic status of students within the schools showed no significant results for any area of organizational health literacy, whereas all eight areas are more likely implemented if the schools already participate in a school health promotion program or network (p < 0.001). Conclusions Participating in a school health promotion program was associated with higher levels of implementation in all areas of organizational health literacy in schools. This finding highlights the importance of those programs. Integrating organizational health literacy into those interventions can be a beneficial approach to sustaining health literate schools. Key messages • Participating in a school health promotion program or network might facilitate schools to become health literate organizations. • In Germany, the socioeconomic status of the students within the schools is not associated with the implementation of organizational health literacy.

Organizational health literacy responsiveness in community pharmacies in Serbia

Abstract Background The Faculty of Pharmacy at the University of Belgrade conducted a pilot study at community pharmacies in Serbia in 2023 in the framework of the M-POHL organizational health literacy (OHL) project. Community pharmacies in Serbia are considered relevant settings where people’s health can be promoted within the organization. Methods The validated and culturally adopted Serbian version of the International Self-Assessment Tool for Organizational Health Literacy in Primary Health Care Services (OHL-PHC) was used. We recruited employees from 3 pharmacy chains with pharmacists from different units. A preparatory workshop was organized to explain the procedure and the concept of OHL. First, the self-assessment was performed in a small group of 5 persons individually, and then the results were discussed in a joint assessment. The self-assessment was based on the degree of fulfillment of 4 categories offered for each indicator: not fulfilled (0-25%), predominantly not fulfilled (26-50%), predominantly fulfilled (51-75%), and completely fulfilled (76-100%). The same scale was applied for the indicators, sub-standards and standards and the final score was the mean of the individual scores (min. 0, max. 4). Results The overall score of the OHL on the sample level was 1.93±0.86, with the highest score for providing of easy access to primary care service and facilitating navigation (2.3±0.5). The least fulfilled standards were related to promotion of digital health literacy and promoting health literacy with the same score values of 1.7±1.0. Out of 69 indicators 1 had been self-assessed as not fulfilled and 15 reached low consensus (SD ≤ 1), and needed to be discussed further. Conclusions Improvements in OHL in the piloted institutions are necessary for successful healthcare and health promotion and could be tailed in further usage of the OHL-PHC on a broader scope. More pilot studies are needed in other healthcare settings at primary level in Serbia.

An action plan to improve organizational health literacy in hospitals in the Czech Republic

Abstract Background The National Institute for Health Literacy conducted in 2023 as part of the M-POHL network and in close collaboration with the team of the Klaudian Hospital a survey on the level of organizational health literacy using the OHL-Hos tool. The OHL-Hos tool was proven by the project implementation team as suitable for initiating and monitoring organizational change. Methods Based on the self-assessment and the results of the consensus workshop, the project implementation team identified development priorities that were submitted and approved by the hospital management. To keep the sustainability of the implementation, the hospital management decided to formulate an action plan, with the time horizon 2025. Results The proposed action plan, approved by hospital management, focuses on feasible measures within a given time horizon. For each development goal, responsible teams, time frames, and expected results were formulated. The implementation project team evaluated as the most innovative standard the standard dealing with internal communication with patients and their family after discharge and thus to ensure the continuity in supporting personal health literacy of patients and relatives. In addition, as further important standards, easy navigation and access to documents, materials, and services for patients and healthcare professionals were recognized. Interventions focusing on public education, especially for children and students of all school levels, have been proposed to enhance external communication and increase health knowledge in the region. Conclusions The process of regular OHL assessment of set up measures has been considered as a way how to ensure the long-term fulfilment of the newly adopted action plan by the hospital.

Organizational health literacy in hospitals and primary health care - developing innovative tools

Abstract Background Organizational health literacy (OHL), particularly in health systems, is vital for supporting public health. Self-assessment tools (SAT), critical for quality assessment/improvement and for empowering relevant stakeholders, could support hospitals and primary healthcare services to promote their role in health literacy responsiveness, and support organizations in identifying strengths and areas of improvement. Methods The SAT for OHL in hospitals (OHL-Hos) and in primary healthcare (OHL-PHC) were developed via a participatory process, based on the “Vienna Concept of a Health Literate Healthcare Organization”. Piloting of the tools in European countries shed light on the tools’ depth and the need for revision. The development of short versions followed a Delphi process with experts from ten to thirteen European countries, respectively, from December 2023 - April 2024. Healthcare service diversity within and between countries was taken into consideration as well as cultural/language adaptation. Shortening OHL-Hos followed four steps: 1) prioritization of the most relevant indicators, 2) considering additional resources, 3) consensus process, 4) refinement of the tool and wording. Results The SATs for both healthcare settings are now established. The SAT for OHL-Hos includes a matrix model of eight standards, 21 sub-standards and 75 indicators. The SAT for OHL-PHC includes seven standards, 19 sub-standards and 69 indicators, covering OHL in organizational structures and processes for staff, patients and the community served with specific focus on navigation, communication, and participation. Both SATs are accompanied by a guide to direct organizations through in the self-assessment process. Conclusions The process of identifying OHL needs and opportunities in the health system, facilitated by participatory methods for tool development, led to innovative SATs for OHL which are currently ready for piloting and implementation in European countries.

4.X.1. Health literacy policies – how can they be developed and implemented?

Abstract In Europe and beyond, there is political recognition of health literacy being an important factor for good health and well-being. As health literacy is considered critical to achieving health and as limited health literacy is still a widespread phenomenon, the topic is steadily attracting more attention among policy and decision makers. To meet growing demand from decision makers, a policy guide was initiated by M POHL, the World Health Organization (WHO) Action Network on Measuring Population and Organizational Health Literacy. The guide aims to support awareness-raising, the building of commitment and the implementation of effective policies to improve health literacy. It mainly addresses decision-makers in health policy and administration, but may also inspire researchers and other relevant stakeholders in the health literacy area. Objectives of the workshop This skills building seminar seeks to contribute to capacity building and to offer time for exchange and discussion on health literacy policy work. More specifically, the objectives of the workshop are to: - provide an overview on national health literacy policy implementation; - increase the knowledge of participants on what countries are doing already and identify needs for further support; - support participants in reflecting, initiating, developing and implementing effective measures to improve population and organizational health literacy. Methods of the workshop The workshop will start off by a presentation introducing the guide “Health literacy policies - how can they be developed and implemented?’ and sharing some national experiences in implementing health literacy policies, strategies, and interventions. After these impulses attendees will be divided into groups to enable exchange. A checklist for self-assessment will be provided as a tool to guide the discussion and to identify and address potential challenges in implementing health literacy policies and interventions. The input and identified needs will be captured. They will support M-POHL’s continuing efforts to support policy makers and administrators in their work. Key messages • Health literacy is steadily gaining more interest from policy- and decision-makers. • In this seminar, participants will learn on how evidence-informed policies and practice can be supported.

3.X.1. Health literacy in Europe: Building a comparative database for shaping public health policy

Abstract Health literacy (HL) is a key determinant of health and a lever for health equity. It refers to the extent to which individuals are able to deal with health-related information, communicate with health professionals, and navigate the health care system to restore, maintain, protect, and improve their health and well-being. It is the result of an interplay between personal motivation, individual competencies and the health information and service environment. HL is strongly related to health behaviors and issues such as obesity, the social determinants of health, and the use of health systems, which have been under pressure since COVID-19. The development and implementation of targeted public health interventions to promote HL in the European Region require reliable and comparable data on population HL to identify the main HL challenges and the most affected population groups. The WHO Action Network on Measuring Population and Organizational Health Literacy (M-POHL) has started monitoring population HL and conducted the first M-POHL Health Literacy Survey (HLS19) in 17 countries in the WHO European Region between 2019 and 2021. In preparation for the 2nd M-POHL Health Literacy Survey (2024-2026; HLS24), the HLS19 instruments were further improved and supplemented by a new measure on mental HL. These instruments are also of interest to the European Joint Action PreventNCD with its specific task on HL and non-communicable diseases (7.4). The workshop will provide insights into the M-POHL HLS24, the largest HL survey in Europe, and the HL instruments used. It consists of four presentations, one describing the M-POHL HLS24 project and three on specific HL instruments used to assess different aspects of HL in the European general population: HLS24-DIGI for digital HL; HLS24-COM-P for communicative HL; HLS24-NAV for navigational HL. Each presentation will describe the revised item set and results from pretests. We invite the audience to ask questions and to engage in a (cross-cutting) discussion with the presenters. Expected impact: The presentations will provide a comprehensive overview of the advanced family of instruments used in the HLS24 study, their quality, and the expected HL data for Europe. They will provide a deeper understanding of how HL will be measured in the M-POHL HLS24 project. Key messages • The advanced family of HL instruments used in the M-POHL HLS24 project enables comprehensive HL monitoring in Europe. • The data collected in HLS24 will provide a solid database for shaping public health policy to strengthen population HL and promote health equity in Europe.

Longitudinal associations of daily activities and presenteeism among teleworkers in Japan

Abstract Objectives Many workers had to switch their standard work from the office to home-based telework during the COVID-19 pandemic. Previous studies reported that telework was associated with increased sickness presenteeism. Several studies have examined the association between lifestyle behaviors and presenteeism among workers. However, there are few studies investigating the relationship among teleworkers. Thus, this study examined the association between daily activities and presenteeism in a longitudinal cohort of teleworkers in Japan. Methods A prospective cohort study with a two-year observation was conducted. The participants were 831 workers belonged to five companies in Japan. For both surveys, self-administered questionnaire surveys on daily activities and presenteeism were conducted. Presenteeism was assessed using the short-form Japanese version of the World Health Organization Health and Work Performance Questionnaire. The data were analyzed using a generalized estimating equation approach, controlling for potential confounders such as age, gender, working hours, position, and health status. Results 742 participants who teleworked in both surveys with no missing answers were analyzed. Among male workers (n = 427), chatting (β = 5.30, 95% CI: 1.52-9.07) and setting daily goals (β = 4.16, 95% CI: 1.52-9.07) were associated with decreased presenteeism. Among female workers, exercise (β = 4.33, 95% CI: 0.95-7.71) was associated with decreased presenteeism. Conclusions Although gender differences were observed, there is preliminary evidence from longitudinal studies that frequent activities such as chatting, setting daily goals, and exercising may protect against presenteeism among teleworkers. Our findings could be used to educate daily telework activities to prevent sickness presenteeism. Key messages • Daily activities during telework may worsen or improve presenteeism. • Social isolation may be an important indicator of presenteeism during telework.

OHL-ALL: a theory-informed and practice-orientated organizational health literacy equity approach

Abstract Background The OHL-ALL initiative was launched by Steno Diabetes Center Sjaelland and the Department of Public Health, Aarhus University and the OHL-ALL scientific group in cooperation with EUPHA-HL and M-POHL in November 2023. The OHL-ALL (Organizational Health Literacy for All) approach offers an opportunity to rethink and develop organizational health literacy (OHL) with an explicit normative basis for equity. The goal is to establish a theory-informed, practice-oriented, multifaceted, and implementable approach. In the OHL-ALL approach, we define equity as the normative anchor, and we suggest using the Capabilities Approach to embed improved equity in design, implementation, and evaluation of interventions. Methods The process of developing the OHL-ALL was guided by applying core ideas from Amartya Sen’s Capability Approach. Five intervention principles were derived from the existing organizational health literacy literature: organizational change, workforce responsiveness, user involvement and person-centered care, access and navigation and internal and external partnerships. After an international expert working group meeting in November 2023, we formed four work packages. Results At the EPH conference, a status of the progress in the four work packages will be presented: WP1. OHL-ALL Framework development based on capability, fairness, and equity. WP2. Initiatives and testing of the OHL-ALL framework. WP3. Evaluation of OHL-ALL (i) the capability approach and (ii) outcome domains. WP4. Plans for the future, including advocacy and outreach - ideally via a conference in 2026. Conclusions The OHL-ALL project presents a novel approach to advancing equity in health by improving users’ capabilities. Based on an explicit normative framework it is expected to offer theoretical and practical guidance for organizations that chose to implement a health literacy approach.

How to measure Organizational Vaccine Literacy: an exploratory cross-country survey

Abstract Background The project AcToVax4NAM (Grant No. 101018349-3° EU Health Programme) aims to ensure equal and guaranteed access to vaccination services for Newly Arrived Migrants (NAMs). The working group developed a tool that measured the level of Organizational Vaccine Literacy (OVL), defined as an organizational effort to make the Health System easier to access and navigate, thereby facilitating informed decision-making regarding vaccinations for individuals, families and communities. Methods A systematic literature review was undertaken to identify validated tools for measuring OVL, but none was found. Consequently, the review was broadened to include tools for assessing Organizational Health Literacy, which were then adapted to define OVL. A questionnaire consisting of 22 questions divided into 7 sections was developed, utilizing a scale of 1 to 5 to gauge OVL. The survey was then distributed among healthcare services in 8 countries of the AcToVax4NAM consortium. Results We received 88 responses, mainly from Italy (26%), Spain (23%) and Greece (12%), encompassing 17 facilities, primarily vaccination centers and health prevention departments. Questions about the clarity and easy access to vaccination information provided by organizations had high mean scores, except the questions on the navigability of websites for foreign patients (mean scores < 3). Notably, responses related to the issue of cross-sectoral collaboration between health services and other partners (e.g., patient associations, NGOs), had a mean score of 2.56. Low scores were observed in the area related to the perception of possible individual contribution to systemic organizational efforts. Conclusions Shifting to an approach in which organizations prioritize equity and address complex needs, rather than leaving it to individuals to navigate the complex world of healthcare providers, could bring benefits to population groups, particularly those at risk of not accessing prevention services, such as NAMs. Key messages • After conducting a systematic review to identify validated instruments for the measure of Organizational Vaccine Literacy (OVL), a tool consisting of 22 questions was developed to measure OVL. • Shifting to an approach where organizations prioritize equity and address complex needs, rather than leaving it to individual responsibility, could significantly benefit vulnerable population.

Health literacy and health-related outcomes among preschool educators: a cross-sectional survey

Abstract Background Given the increasing use of childcare services and the shortage of skilled workers, preschool educators are under particular pressure. Health literacy has previously been shown to be an asset for stress and well-being in school principals. Within the organizational health literacy in preschools project, the Health-Literate Preschools Survey aims to assess educators’ health literacy levels and investigate differences in health-related outcomes based on these levels. Methods Preschool educators from a Bavarian county participated in a cross-sectional online survey in February 2024. Sociodemographic information, health literacy, and health-related outcomes (well-being, exhaustion, psychosomatic complaints) were assessed using established self-report tools. Descriptive statistics and variance analyses were carried out using SPSS. Results The sample consists of N = 114 preschool educators from a Bavarian region (94.6% female, Ø 41.5 years). Of the educators, 23.7% showed adequate, 50.0% problematic, and 26.3% inadequate health literacy levels. Kruskal-Wallis H analyses indicated statistically significant differences in well-being (H(2, n = 113) = 14.200, p < 0.001), exhaustion (H(2, n = 114) = 6.098, p = 0.047), and psychosomatic complaints (H(2, n = 114) = 8.910, p = 0.012) across health literacy levels. Conclusions The survey provides first-time insights into preschool educators’ health literacy and health-related outcomes in Germany. Only one-quarter of preschool educators demonstrated adequate health literacy levels. Further, the findings confirm the link between health literacy and well-being and stress already shown for other samples. Health promotion initiatives for preschool staff should focus on strengthening educators’ health literacy, especially given their role model function for children. Key messages • This survey is the first assessment of health literacy among preschool educators, which is an important target group given their role model for young children. • Preschool educators demonstrated overall low levels of health literacy, which is associated with well-being, exhaustion, and psychosomatic complaints.

Examining the relationship between religious volunteering and mental health screeners among firefighters

ABSTRACT Firefighters experience a high level of traumatic incidents in their work. This high level of exposure puts them at risk for trauma-related symptoms. These trauma symptoms include PTSD, suicide risk, alcohol misuse, and depression, and anxiety. Furthermore, repeated exposure has been found to lead to desensitization, flashbacks, irritability, and PTSD. Exposure to natural disasters may also impact ecospirituality. A survey was designed to include the Life Events Checklist, PHQ-9, GAD-7, PCL-5, and the SBQ-R. This survey was administered to firefighters from Northwest Florida in the fall of 2020 and spring of 2021. Participants were found to have higher levels of PTSD, anxiety, depression, and suicidal risk than the general population. Participants were further asked about their volunteering for religious organization activity. A significant relationship was found between volunteering for religious organization and mental health screeners. Religious volunteering predicted lower levels of PTSD symptoms, depression, and anxiety. The effect size was small.

Investigating toxic leadership’s influence on employee turnover intention in a clinical research organisation

Orientation: This study examines the impact of toxic leadership (TL) on employees’ intentions to leave a South African clinical research organisation (CRO) and how organisational culture (OC) mediates this relationship.Research purpose: The research aimed to evaluate how toxic leadership behaviours affect employee turnover intentions (TIs) and determine to what extent OC mediates this relationship.Motivation for the study: In the context of CROs, the negative impact of TL on the retention and health of employees and organisations, in the case described in this article, is crucial to understand and mitigate.Research approach/design and method: This study used a quantitative and cross-sectional correlational design to collect data on employee perceptions of TL and OC within the CRO.Main findings: Toxic leadership significantly impacts employee TIs, and the OC is an essential mediator in this relationship.Practical/managerial implications: The results highlighted the need for organisations to address toxic leadership and to actively cultivate a positive OC to improve employee retention and reduce TIs.Contribution/value-add: This research provides empirical evidence of toxic leadership’s impact on TIs and the extent to which OC mediates this relationship. It reveals how OC mediates this relationship. The study contributes to the widest literature on leadership and organisational behaviour. It provides valuable insights into management practices for improving organisational health and employee well-being.

Working conditions of commercial drivers: a scoping review of psychosocial work factors, health outcomes, and interventions

BackgroundPsychosocial work factors significantly influence both organisational and worker health. Poor management of these factors can create precarious working conditions, risking drivers’ health. This review maps evidence on the health impact of these factors and health interventions targeting the working conditions and unhealthy habits of commercial drivers.MethodThe search was conducted in four main databases (PubMed, Central, JSTOR and Dimensions Ai) and other sources like Google Scholar. In All, 28,039 articles were retrieved and through a rigorous screening process, 68 records were included in this scoping review.ResultsThis review found that drivers work in precarious conditions like long driving hours, low job resources and social support, low job control, poor remuneration, workplace abuse and sexual harassment, work-family conflict, lone driving hour, irregular shift work, lack or insufficient breaks during work hours and difficult access to social protection and sanitation facilities. These precarious working conditions may expose drivers to mental health issues, cardiovascular diseases, HIV/AIDs, stroke, chronic fatigue, kidney and bladder issues and musculoskeletal pains. Most health promotion interventions target behaviour at the individual level, such as the benefits of a healthy diet and exercise, with little effort to improving working conditions.ConclusionEmployers in the road transport sector need to implement health promotion interventions that focus on drivers’ well-being. Additionally, improving working conditions and enforcing occupational health and safety standards in the road transport sector are essential for creating a safe and healthy workplace for all commercial drivers.

Late-onset caloric restriction improves cognitive performance and restores circadian patterns of neurotrophic, clock and epigenetic factors in the hippocampus of male old rats.

Aging is a complex multifactorial process that results in a general functional decline, including cognitive impairment. Caloric restriction (CR) can positively influence the aging processes and delay cognitive decline. There is a rhythmic variation in memory and learning processes throughout the day, indicating the involvement of the circadian clock in the regulation of these processes. Despite growing evidence on the efficacy of CR, it has not yet been fully determined whether starting this strategy at an advanced age is beneficial for improving quality of life and eventually, for protection against age-related diseases. Here, we investigated the effect of late-onset CR on the temporal organization of the molecular clock machinery, molecules related to cognitive processes and epigenetic regulation, in the hippocampus of male old rats maintained under constant darkness conditions. Our results evidenced the existence of a highly coordinated temporal organization of Bmal1, Clock, Bdnf, Trkb, Dnmts, Sirt1, and Pgc-1α in the hippocampus of young adult rats. We observed that aging led to cognitive deficits and loss of circadian oscillations of all the above variables. Interestingly, CR restored circadian rhythmicity in all cases and, in addition, improved the cognitive performance of the old animals. This work would highlight the importance of the circadian clock and its synchronization with feeding signals, as the basis of the beneficial effects of CR. Thus, lifestyle modifications, such as CR, might be a powerful intervention to preserve hippocampal circadian organization and cognitive health during aging.

An exploration of factors leading to readiness for organizational health literacy change in community-based health organizations.

Healthcare systems have a responsibility to improve organizational health literacy (OHL) to increase health equity. This study explored two organizational cultural factors, leadership support and staff buy-in, for organizations planning OHL change. Ten community-based health organizations participated in an OHL program. The study design was mixed methods. The qualitative inquiry was interviews with senior leaders to explore awareness of OHL and: impetus to transform, leadership commitment, staff engagement, alignment to organizational goals, and integration of health literacy change with current practices. The quantitative assessment was the Organizational Readiness for Implementing Change (ORIC) questionnaire to assess staff's perceptions about OHL change readiness. Senior leaders articulated the effects of low health literacy in their patient and client population. Support for OHL change was seen at both leadership and staff levels. Impetus for change was primarily a response to a community need or for quality improvement. Most of the non-clinical organizations had higher ORIC scores than the clinical organizations, indicating a perceived higher level of readiness for OHL change. Leadership commitment and staff buy-in are important factors of readiness for OHL change. A novel finding is that community-based health organizations are able and willing to engage in OHL change.

Exploring Differences in Leadership Behaviors and in the Perceived Work Environment Between Younger and Older Managers in a Swedish Mining Company

AbstractThis study examines differences in leadership behaviors and in the perceived work environment between older and younger managers in a large Swedish mining company. The leadership behaviors and work environment of young managers in the mining industry will become more important in the future due to the changes taking place in the industry. Such changes include the older generation of managers reaching retirement age, while the industry generally finds it difficult to recruit a younger generation of employees. Moreover, rapid technology-centered transition, such as the green transition of the mining industry, is underway which may put young managers in particular under pressure. Meanwhile, research on young managers in the mining industry more broadly is sparse. Data for this study was mainly gathered via a questionnaire, complemented by data from interviews. The questionnaire included 48 validated self-rate questions on background variables, social and organizational working conditions, health, and leadership behavior. The survey was answered by 216 managers (response rate: 63%). Interviews were carried out with ten young managers (35 years or younger). The study found no statistically significant differences between younger and older managers with regards to workload, working hours, health, and work satisfaction. We found that older managers rate themselves higher, at a statistically significant level, for change-oriented leadership behaviors. However, when age is analyzed together with other variables that are significantly different between the two groups, only managerial experience and managerial positions show statistically significant associations with change-oriented and healthy and effective leadership behaviors. The interviews indicate that the young managers encounter challenges that are related to their experience and training, but few are related to their age. Given the influence of managerial experience on leadership behaviors, leadership training appears to be an important area of intervention, and conditions must be improved to enable change-oriented leadership among managers in the mining industry, with a greater focus on young managers.

Organizational health literacy in German hospitals: a cross-sectional survey among hospital managers

BackgroundOrganizational health literacy (OHL) describes conditions and measures in healthcare institutions to enable patients to make good health-related decisions. By providing easy access to and appropriate communication of understandable information to use and navigate the facility, healthcare organizations can contribute to strengthening patients’ health literacy and self-management. The extent of OHL implementation in German hospitals remains largely unknown. This study aims to fill this gap in our knowledge by investigating OHL-related activities reported by hospital managers.MethodsBetween November and December 2022, we conducted a national online survey among medical, nursing and administrative hospital managers with hospitals that operate more than 50 beds. The data were collected via the health literate health care organization ten item questionnaire (HLHO-10) and supplemented by sociodemographic questions and an open-ended question. We applied variance and correlation analyses to investigate the data.ResultsOf 3,301 invited hospital managers, 371 participated in the survey (response rate 11%). The overall mean score for HLHO-10 was 4.6 (SD = 1.1) on a 7-point Likert scale, indicating a moderate level of OHL implementation. Hospital managers stated that hospitals concentrate on helping patients find their way around and communicating the costs of treatment transparently and clearly; conversely, that active patient participation in the design and evaluation of health information is rare in care settings, and that health information is seldom provided to patients through a range of media. For the practical implementation of the OHL, most hospital managers mentioned activities regarding communication standards, such as providing information materials.ConclusionsGiven their unique position as hubs of human interaction, hospitals provide an ideal opportunity to promote the adoption of OHL. By actively involving patients, hospitals can better tailor their approaches to meet patient needs and preferences. Compared to studies from oncology centres in Germany and 20 Italian hospitals, the average HLHO-10 score of this study is lower. While some aspects of OHL are already embedded in inpatient care, it is imperative that OHL is thoroughly embedded in the hospitals’ organizational culture and plays a fundamental role in the daily operations of the institution. This could be done, for instance, by more explicitly addressing the topic of health literacy in staff communication training.