Organizational Health Research Articles

The compensatory protective effects of organizational and supervisor support for nurses’ morale in sickness presenteeism: a three-way moderated mediation model

PurposeThe present study explored sickness presenteeism as a linchpin connecting prolonged working hours to elevated turnover intention among hospital nurses (mediation). In addition, we examined the joint moderating effects of organizational health care support and supervisor support on the second stage of the “long working hours-presenteeism-turnover” process (three-way moderated mediation).Design/methodology/approachWe conducted a two-wave survey to collect data over a four-month period from hospital nurses in Taiwan. The final sample for analysis had 294 nurses.FindingsWe found that presenteeism partially mediated the elevated turnover intention after working long hours four months later. We also found a significant three-way moderation effect of organizational health care support and supervisor support on the positive relationship between presenteeism and turnover intention. Specifically, nurses reported the lowest turnover intention with high levels of both organizational healthcare and supervisor support, the highest turnover intention with both support being low, and the intermediate level of turnover intention when any one of the support was high.Practical implicationsOrganizations should build a positive work environment through organizational health care support and supervisor support to retain talents.Originality/valueOur findings suggested that support resources of different origins (organization-level vs line supervisor) can compensate for one another to protect the employees in demanding work conditions. Our moderated mediation model exploring the psychosocial context of presenteeism has theoretical contributions pivoting on the interplay of resources at different levels in the organization as well as practical implications for presenteeism management.

Critical Evaluation of Neglected Consensus Risk Factors Causing the Recurrent Upsurge of Cholera Outbreaks in Some Regions in Cameroon: A Systematic Review

Background: Cameroon is a developing nation and has been enlisted amongst the several countries in sub-Sahara Africa situated in West and Central Africa to be experiencing the recurrent cholera outbreaks. The World Health Organization (WHO), Cameroon health authorities and others researchers have considered a few risk factors that are believed to be contributing to the current and on-going cholera outbreaks in Cameroon. These risk factors include the wide circulation of Vibrio cholerae in the country, limited access to safe-drinking water in some areas, a seasonal pattern of cholera re-occurrence and inadequate water, sanitation and hygienic (WASH) conditions, unstable political atmosphere that have resulted to internally displayed persons, very poor and vulnerable persons, refugees and humanitarian crises and continued unnecessary imposed lock-downs and road-blocks. However, despite these enormous efforts made by Cameroon health authorities so far and its partners over the past decades in responding and tackling all these risk factors, the recurrent outbreak of cholera in Cameroon still remained a great challenge and potential humanitarian crisis, an unendingly reality with bewilderment amid uncertainty, threatening and vulnerability to many affected regions. Aim: This systematic review seeks to critically evaluate, identify and classify some previously overlooked consensus risk factors driving cholera endemicity, pandemicity or epidemicity in Cameroon. By highlighting these neglected factors, this review hopes to inform evidenced -based intervention to finally combat the persistence recurrent upsurge and burden of future outbreaks of cholera in Cameroon. Methodology: The current Systematic reviews gathered information from various sources using different search engines provide a comprehensive overview of existing research. These include Academic Search Engines, Specialized Search Engines, Grey Literature, Primary Sources, Secondary Sources, Registers and Repositories, Open Access Sources, Hand Searching and Other Sources. Results: The current systematic review gathered information from diverse sources and identified and classified six groups of neglected consensus risk factors, along with their associated variables, contributing to cholera outbreaks in Cameroon. Additionally, the review assessed the level of intervention and preventive measures offered by the Cameroon health authorities and other stakeholders, categorizing them as either low or high, for both documented and undocumented strategies. All data sources were thoroughly referenced accordingly ensuring transparency and accountability. Conclusion: In spite of extensive research by the World Health Organization and Cameroonian health authorities identifying and documenting numerous risk factors contributing to Cameroon's ongoing cholera outbreaks, these efforts have not prevented or eradicated recurring episodes. Decades of enormous work and efforts by Cameroonian health authorities have been incapable to eradicate cholera. This systematic review unequivocally shows that without addressing the neglected consensus risk factors and variables, Cameroon could face a high likelihood of continued cholera outbreaks. Therefore, this review underscores the urgent need for Cameroon health authorities to adopt a multifaceted approach, addressing the identified neglected consensus risk factors and variables. Implementation of targeted interventions, strengthened health infrastructure, and community engagement are crucial to prevent future cholera outbreaks. Future research should focus on developing context-specific solutions, enhancing existing strategies, and evaluating the effectiveness of interventions.

Physical Engagement in Face-to-Face Interaction Is Associated with Depressive Symptoms of Interaction Partners in the Workplace

Individuals develop interdependence through interactions. The process of physical coordination during face-to-face interactions facilitates relationship formation, emotional experiences, and emotional contagion. Workplaces inherently involve organic and continuous face-to-face interactions. Examining the interpersonal association between physical movement and emotional state among employees in the workplace is crucial for understanding an organization’s emotional dynamics. This study investigated the association between patterns of physical engagement during face-to-face interactions and depressive symptoms with those of interaction partners in a real-world workplace setting. The analysis utilized face-to-face interaction data from 449 employees across ten organizations, measured using wearable devices, along with a self-reported depression scale. The results showed that employees’ average physical engagement negatively correlated with the average depressive symptoms of their interaction partners, rather than their own. The association remained robust regardless of the number of relationships or workplace type. Furthermore, the depressive symptoms of individuals who had a significant influence on interpersonal relationships within organizations negatively correlated with their and their partner’s physical engagement. Our findings have important implications for the epidemiological understanding of organizational mental health in relation to face-to-face interactions among employees.

4.K. Scientific session: The realm of the information ecosystem and its public health impact

Abstract Workshop background As a field of science, study, practice, and policy, infodemic management has emerged during the Covid-19 pandemic but has since been emancipated and can be translated to any topic where information ecosystems play a vital role. In particular relevant to public health, infodemic managers have grown in the ranks of institutes of public health, academic institutions, UN agencies and civil society organizations, tackling outbreaks and public health issues as wide as mpox, Marburg, teen mental health, chronic diseases, seasonal influenza, Ebola and routine immunization. Aiming at improving public health strategies, they are responsible for exploring and investigating personal and organizational (health) information ecosystem, generating evidence, identifying patterns of communication and information flow, tackling the onset and distribution of circulating mis- and disinformation, better understanding information voids, and respond to citizen needs concerning information demands around emergencies. In this workshop, we will focus on several common challenges associated with implementing whole-of-society interventions and strategies for resilience to health misinformation. Solving these challenges, which often are too big just for the health system to solve, will sometimes require creativity, out-of-the-box thinking as well as cross-disciplinary perspectives and new partnerships. Infodemics are also a global challenge that can easily cross borders, which is why country-to-country discussions of experiences by participants is encouraged-while no previous infodemic management experience is required. Workshop objectives The workshop will be organized as a research symposium with five speakers from infodemic management, health information, and health literacy. They will provide a solid introduction to infodemic management from different perspectives and angles. (i) The first presentation will introduce a study on health information seeking and health literacy in midwife-led care and the modern information environment. (ii) The second presentation will discuss how fact-checking organizations can partner within public health for a healthier internet. (iii) The third presentation will focus on unravelling misinformation by investigating the associations between health literacy and resilience. (iv) The fourth presentation will present a novel web-platform for credible health information and tackling misinformation. (v) The fifth presentation focuses on the impact of misinformation on social media in the context of natural disasters. The format of this workshop will be 5x8-minute presentations, including Q&A with the audiences, followed by a 20-minute panel discussion, reflecting the relevance of the results to public health research, practice and policy. Key messages • Infodemic management seeks to quickly understand the public’s information and health needs improve future public health responses, especially during emergencies. • Whole-of-society approaches are needed to address and mitigate harms caused by infodemics by developing closer partnerships and understanding between health systems and the public.

3.D. Round table: Improving equity in health: Understanding and responding to health literacy as a social determinant

Abstract Evidence of a social gradient in health literacy has been found in all reported national population surveys in Europe. This workshop will examine the explanations for this social gradient and explore ways to optimise the contribution that health literacy makes in mediating the causes and effects of established social determinants of health. This will include consideration of practical approaches to improving health literacy in socially disadvantaged populations as a contribution to reducing health inequities within and across European countries. The workshop will explore the concept of critical health literacy and the potential to improve public awareness of and capacity to act on the wider social determinants of health. It will also draw upon existing evidence from interventions that demonstrate the feasibility of improving health literacy among higher-risk and diverse populations. This will include consideration of approaches to improving frontline professional skills and support; approaches to organizational and systems health literacy, working directly with people to develop critical skills in accessing, understanding and applying health information; and ensuring that in public health policy, priority is proportionate to need - reaching and engaging the population groups disproportionately affected by low health literacy. Recognising that research remains underdeveloped and the effects of interventions on health inequity are largely untested, the workshop will also consider where the most important research gaps exist and where future health literacy research should be prioritised. The workshop chair will provide introductory and summary remarks to the workshop. The co-chair will manage the panel discussion and audience participation in the workshop. The individual panel members will make 3-minute introductions to key issues from different perspectives examining the mediating and moderating role of health literacy in addressing the social determinants of health. The panel is made up of individuals from academic and policy roles and at different career stages who can offer complementary perspectives on these issues. Following the presentations, the co-chair will present some follow-up questions to the panel before engaging directly with the workshop participants for an open discussion scheduled to last for 30 minutes of the workshop. Key messages • Improving health literacy is not a panacea for entrenched inequities in health but can help moderate the impact on health of other social determinants and provide an important practical response. • Public health policy and practice intended to improve health literacy should prioritise reaching and engaging the population groups disproportionately affected by low health literacy. Speakers/Panelists Gill Rowlands Newcastle University, Newcastle, UK Stephan Van den Broucke Université Catholique de Louvain, Louvain-la-Neuve, Belgium Ana Rita Pedro NOVA National School of Public Health, Lisbon, Portugal Christina Dietscher Austrian Ministry of Health, Vienna, Austria Susie Sykes London South Bank University, London, UK

2.K. Scientific session: Promoting organizational health literacy in healthcare organizations and beyond in Europe

Abstract Organizational health literacy (OHL) has been defined as the degree to which healthcare organizations equitably enable/empower people, through organizational structures, policies, and processes, to find, understand, appraise, and use information and services to make health-related decisions and actions for themselves and others. By adopting an OHL approach, healthcare organizations enhance health service delivery by simplifying interaction with health systems by making information and services more comprehensible. An OHL approach not only reduces health literacy demands of patients, but also of workforce and the resident population of the community that they serve. The workshop focuses on two theory-based initiatives that focus at promoting OHL in Europe: (1) the Organizational Health Literacy for All (OHL-ALL) initiative, which developed a practice-oriented OHL approach for organizations promoting equity explicitly to support people in vulnerable positions with or at risk for diabetes or other non-communicable diseases, and (2) the World Health Organization (WHO) Action Network on Measuring Population and Organizational Health Literacy (M-POHL) which aims at initiating and facilitating the (self-) assessment of OHL in healthcare organization by developing, providing, and disseminating OHL assessment tools. Both initiatives strive to support organizational change and workforce responsiveness. While the first initiative goes beyond health literacy responsiveness of healthcare organizations intending to offer guidance for organizations on how to give all individuals the best possible opportunities to achieve their optimal health and well-being, the second initiative specifically focuses on OHL in healthcare organizations using a settings approach with a focus on health care, prevention, and health promotion. The initiatives enrich and complement each other. The workshop consists of five short presentations, followed by a discussion among the presenters and the audience. The first presentation focuses on the development of the theory-informed and coherent OHL approach of the OHL-ALL initiative. The second presentation provides an overview of the M-POHL initiative and its innovative tools. Then three presentations will showcase results, experiences, and outcomes from European countries on assessing OHL in different healthcare settings. Expected impact: Theory-based guidance for implementing organizational development will be provided. Results from the M-POHL initiative will contribute to greatly needed insights into OHL needs and opportunities of healthcare organizations. The insights from these real-world assessments and implementation can inform future public health practice, policy, and research. Key messages • An OHL approach contributes to better equity. It helps meet health literacy needs of patients, health and care workforce and the resident population of the community that are served. • New tools have been developed to support management and health and care workforce in assessing and improving OHL responsiveness, to better serve patient communities.

Organizational health literacy strength and learning opportunities in Italian hospitals

Abstract Background Organizational Health Literacy (OHL) implies responsiveness and friendliness of healthcare organizations. In the context of the WHO Action Network M-POHL, Italy evaluated OHL in a hospital as a pilot. Methods The international self-assessment tool OHL-Hos explores 8 standards using 141 items. It was firstly translated and culturally adapted to Italy, and then tested to assess OHL in the public general hospital of Pistoia (Central Italy). A physician, 6 staff members of the healthcare management unit, and 3 medical residents in public health from the Florence University were involved in the pilot. The Pistoia hospital has 1,300 employees (44% nurses, 24% physicians) to face 18,000 hospitalizations per year. Results Completing the questionnaire took more than 5 hours. A comprehensive agreement was reached, even though different approaches aiming at improving HL in healthcare and non-healthcare staff emerged. Scores resulted acceptable/good for standard 5 (communication with patients) and 7 (promoting staff HL with regard to occupational risks and personal lifestyles), low for standards 1 (implementing OHL overall the hospital), 2 (involving stakeholders in developing documents, materials, services), 3 (staff training for personal and organizational HL) and 8 (contributing to local population personal HL improvement), which would apply more peculiar for other settings than hospitals. Conclusions The participation of the hospital working group in the assessment using the OHL-Hos raised interest toward this matter. It results time consuming for its excessive length, and some standards do not fit to the Italian hospital context, resulting more useful to assess the territorial organization. Reduction of the number of items and revision/reformulation of some of them are suggested. Nonetheless, the tool proved to be useful in indicating the most critical areas needing ad hoc interventions, such as training all the hospital staff.

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.