Strengthen Health Literacy Research Articles

Community Nursing for people with a migration biography: a qualitative study

Community Nursing for people with a migration biography: a qualitative study Abstract: Background: People with a migration background or with special socio-cultural needs have difficult access to health services or are affected by overuse, underuse or misuse. Community Nursing (CN), which was implemented in March 2022 in a district in Austria, can strengthen health literacy and promote individual well-being. Aim: The aim was to obtain information about perception and use of CN services by people with a migration biography and to identify adequate measures to promote increased use. Methods: In March 2023, two focus group interviews with stakeholders and people with a migration biography regarding the use of the CN service were conducted, analyzed and validated in workshops in a municipality in Vorarlberg. Results: Diverse barriers (lack of language skills, lack of knowledge about own insurance coverage, lack of information, emotional inhibiting factors such as fear, shame and reservations about care services) were identified. The jointly developed solutions for a low-threshold offer range from the use of key persons, and health counseling in meeting cafés, to a targeted information strategy. Conclusions: A successful CN service requires a comprehensive implementation strategy and needs-based measures. The identified barriers, fears, and reservations should be considered to facilitate access to CN for people with a migration background.

Does School Education Improve Children’s Health Literacy? Evidence from a Performance-Based Survey

Abstract Background Children begin using digital sources of health information at a young age and are quickly exposed to a variety of unmoderated health content. Health literacy helps children navigate, understand, evaluate, and act on this content. But is the educational system preparing young people for these tasks? This study develops a validated, performance-based measure of health literacy and applies it to a sample of 9- to 13-year-old children (grades 4 to 7). Methods A performance-based tool to measure children’s health literacy was developed through expert consultation and qualitative and quantitative pretesting. The tool uses vignettes and quizzes and captures three dimensions of health literacy: nutrition, physical activity, and psychosocial health. The validated tool was then used in a cross-sectional survey of Austrian children aged 9 to 13 years (n = 780): Diet, Physical Activity, and Psychosocial Health. Results Results show that the performance-based health literacy scores do not correlate with self-reported scores. Girls (vs. boys) and native speakers perform better on the performance-based literacy test, while boys and children reporting more robust financial backgrounds overestimate their literacy on self-reported questions. Most importantly, the data do not show meaningful increases in performance-based health literacy across grade levels. For nutrition literacy, the study even shows a slight negative trend across grade levels. Conclusions This study questions the heavy reliance on self-reported health literacy, which is often confounded with self-efficacy and social environment. Performance-based instruments are needed to measure health literacy as an educational outcome. This study presents one of the first validated instruments. Most importantly, the study shows that the current educational system may not produce meaningful increases in performance-based health literacy, calling for deeper educational reforms. Key messages • Performance-based health literacy is a distinct concept from the subjective health literacy measures that dominate current health literacy research. • Performance-based health literacy did not increase with grade level, indicating a poor performance of the education system in strengthening health literacy.

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.

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.

The empowering role of health literacy in combatting fake news, misinformation and infodemics

Abstract Background In times of the rapid digital transformation, people need to acquire specific knowledge, skills and attitudes to deal with data, digital information and technology. Such skills are particularly important in times of crisis, as the COVID-19 pandemic has shown. Alongside the pandemic, a so called “infodemic” has emerged, i.e., an overabundance of information, accompanied by misinformation, which impedes sound decision-making processes, affects health literacy (HL) and impacts public health. However, while misinformation poses a well-known threat to our health and well-being, we still lack viable concepts and approaches to satisfactorily solving this issue. Thus, we aimed at reviewing the concept of HL in view of the infodemic and health-related challenges. Methods In a 12-month participatory process in Switzerland in 2023, we investigated the empowering role of HL in light of the polycrisis. On behalf of the Swiss Federal Office of Public Health, we conducted a literature review on existing HL definitions. Then, we conducted 6 expert interviews and 2 focus group interviews with other 10 experts in HL and associated domains, which guided and informed the review process. Results As a result, HL can be understood as a bundle of competencies to proactively deal with health-related information, services, and challenges and thereby empowers people to manage their and other’s health and well-being. Thus, HL empowers people to better manage digital information and services and promotes critical thinking. This in turn is necessary to assess information quality, uncover misinformation and to adequately manage health data and information. Conclusions HL represents a crucial prerequisite for individuals, professionals, and decision-makers to find trustworthy health information, to reflect upon the quality and credibility of sources and content, and to understand the complex interrelations of the determinants of health and is therefore crucial for public health. Key messages • Health literacy empowers people to adequately deal with fake news, misinformation and infodemics. • Strengthening health literacy offers great potential for public health to promote critical thinking and to rebuild trust.

Health literacy development using a short drama programme for dengue fever control in Thailand

Background: Dengue is a viral infection that spreads from mosquitoes to people. It is especially prevalent in tropical and subtropical regions of the world. To address the challenges posed by dengue in countries such as Thailand, effective prevention and control to strengthen health literacy at the community level is needed. One way of achieving this goal is to work with village health volunteers (VHVs). This article documents the use of VHVs for dengue fever prevention in Mueang district, Khon Kaen province, northeast Thailand. Method: A quasi-experimental study was conducted. The experimental group comprised 45 people who received a programme that aimed to enhance health literacy through the provision of knowledge and social support by community-based volunteers accompanied by a short drama programme. A group of 45 people receiving health services without the drama programme comprised the comparison group. The duration of the activity was 12 weeks. Data were collected by means of a pre- and post-test survey and were analysed using descriptive statistics and a comparison of mean health literacy and practice scores before and after the intervention. Results: Following programme delivery, the experimental group had a mean health literacy score which was significantly higher than that of the comparison group, while the mean practice score of the experimental group was also higher than that of the comparison group. Conclusion: The results suggest that a health literacy programme which includes a short drama programme could be effective in bringing about desired changes with respect to dengue fever prevention. The programme provided in this study was effective and easy to understand. The model developed here could also be useful in other villages in epidemic areas.

Survey on health literacy and related factors among firefighters of emergency management departments in Southwest China

ObjectiveAlthough health literacy (HL) has emerged as a critical public health concern, research on HL in emergency management departments is limited. This study aimed to investigate the awareness of HL and associated factors among firefighters of emergency management departments in southwest China to provide a basis for carrying out targeted health education.MethodsA cross-sectional convenience sample of 1,742 firefighters from an emergency management department in southwestern China was surveyed from February to April 2023 using the Chinese Citizen’s Health Literacy Questionnaire (2019 version). The chi-square test, linear trend chi-square test, Fisher’s test, rank sum test, and multifactorial logistic regression model were used to identify influential factors associated with HL.ResultsThe HL level of the 1742 respondents was 34.3%. Age, ethnicity, education level, length of service, type of job, smoking status, types of parental jobs, annual household income, time of daily internet use, etc. (P < 0.05). The results of multivariate logistic regression analysis indicate that type of job (OR = 0.648, 95%CI:0.426–0.985), length of service (OR = 0.496, 95%CI:0.251–0.981), household income (OR = 1.900, 95%CI:1.443–2.502), daily internet usage time (OR = 0.726, 95%Cl:0.588–0.896), health status (OR = 0.750, 95%Cl:0.585–0.962) and frequency of organizing HL sessions (OR = 1.603, 95%Cl:1.101–2.330) were influencing factors affecting the HL of the officers and soldiers.ConclusionThe health literacy level of firefighters in the Emergency Management Department in Southwest China was 34.3%. Lower levels were found in the health-related skills dimension (HRS, 30.1%) and in infectious disease control (ID, 30.7%). Health information literacy (HI, 34.3%) was lower than the national level. The type of urban and rural areas, literacy level, and household income level may be the factors affecting the level of health literacy among the respondents. Therefore, health education and promotion interventions should target high priority dimensions (HRS, HI, and ID) and should focus on strengthening health literacy levels of firefighters with rural types, low education levels, and low household income to improve their health.

Strengthening Health Literacy for Prevention and Management of Risk Factors for Non-Communicable Diseases (NCDs) in Gedangsari, Gunung Kidul

Non-communicable diseases (NCDs) are diseases that are often not widely detected and recognized because generally, NCDs do not cause symptoms or complaints. This has an impact on the examination of patients where NCDS are detected to have reached the final stage. The lack of citizen’s literacy regarding non-communicable diseases due to the lack of exposure to information is crucial to follow up because it has an impact on the lack of attitudes and behavior in the prevention and management of NCDs in the Gedangsari area. Access to health services is considered to be lacking because the distance to health services is quite far, plus the geographical conditions of the area and quite steep road conditions. Economic factors and the level of education of residents are also obstacles to the access of information and health services. NCDs prevention efforts are urgently needed so that the level of public health in the Gedangsari area increases. Prevention is meant through Information Communication and Education activities about NCDs to the public. This community service aims to increase public knowledge about NCDs and how to prevent and treat them. This activity was carried out by early detection of NCDs risk factors, health checks, presentation of material about NCDs general knowledge, and NCDs modality therapy. The activities carried out were evaluated through a pre-test and post-test with a questionnaire. The results of the activity showed that there was an increase in residents' knowledge regarding NCDs by 51,2% after the activity, the implementation of NCDs screening, and NCDs modality therapy. In conclusion, this community service activity can increase citizen literacy towards NCDs. It is hoped that the community will apply the preventive and therapeutic modalities that have been taught to prevent and control NCDs

“Light through Life”– an inter-disciplinary long-term integrated health promotion programme for overweight and obese people

Introduction/Background: In 2019, around half of the Austrian adult population was overweight or obese, and this has only worsened during the COVID-19 pandemic. While research is clear that sustainable weight loss needs a long-term and holistic approach to support lifestyle changes and address the underlying causes of overweight and obesity, most weight loss programmes offer only short-term and single intervention solutions, with a focus on either raising physical activity or changing nutritional habits. To raise the potential for success and translate research into practice, the Austrian Social Insurance Fund for Public Service, Railway and Mining Industries developed “Light through Life”, a long-term integrated health promotion programme, which started in January 2022.&#x0D; Who is it for? The programme was developed by an interdisciplinary team of the social insurance fund and is offered to their adult insurees, who are overweight or obese. They can register themselves, be transferred by their GP or continue after other health promotion and rehabilitation programmes offered by the social insurance fund. The programme itself consists of three phases, which are designed to progressively enable participants to not only manage their weight, but self-sufficiently design their own healthy lifestyle. Regular monitoring, participant feedback and an independent evaluation ensure that a continuous improvement process takes into account the needs of the participants and adjust the programme accordingly.&#x0D; What did you do? “Light through Life” aims to strengthen health literacy and self-management skills of the participants by focussing on four themes: clinical aspects, physical activity, nutrition, and mental health. In addition they receive ongoing support through prevention coordinators. The first phase is a 6-months intensive basic programme, which combines face to face lectures with practical classes covering the four topics. The focus is on creating an understanding of what influences their health and thus their weight and how to manage it differently. The participants learn in groups to create a community of practice. The programme encourages participants to set their own goals and monitor them. In the second phase, the year- long “Pro” programme the support offered changes to coaching and more person-focussed training. In this phase, participants should be able to manage themselves, with thematic workshops and trainings reinforcing the learned content or addressing specific needs. Participation throughout the programme is voluntary.&#x0D; What results did you get? What impact did you have? The programme was introduced with an independent evaluation in place. The evaluation uses a mixed methods approach, analysing both process and outcome measures for participants and professionals. The comprehensive quantitative data collected through regular clinical examinations and an extensive lifestyle questionnaire will enable a better understanding of which elements work and which need improvement. A first, preliminary analysis of the baseline data and after 6 months shows weight and waist circumference reductions in all groups safe obese men (above BMI of 36). More detailed analyses also including mental health and e.g. the urban-rural divide will be available for the conference.&#x0D; With a comprehensive analysis of the first year of the programme, recommendations will be formulated.&#x0D; &#x0D; &#x0D;

Relationships between COVID-related health literacy, mental health and workload of school leaders

Objective: Studies have shown that school leaders’ health literacy is key to supporting health development in school. During the COVID-19 pandemic, the importance of school leaders’ health literacy became evident, as school leadership was characterised with uncertainty and demanded high levels of alertness to the need to implement rapidly changing health-related measures at short notice. This study sought to explore school leaders’ health literacy, mental health and work-related characteristics in Danish public primary and lower secondary schools during the pandemic. Methods: Selecting schools from the national Danish register of institutions a sample of 220 complete responses was achieved in a cross-sectional survey. School leaders or a member of the school management team completed a self-administered version of the COVID-HL: School Principals Survey, which assessed health literacy, three domains of mental health, sense of coherence and workload. Data were analysed using chi-square tests and logistic regression. Results: The majority of school leaders (71.4%) demonstrated a sufficient level of health literacy. However, there was a significant difference in workload increase between those with sufficient (66.0%) and insufficient (81.6%) health literacy. A high general workload was associated with lower well-being, while an increase in workload during the COVID-19 pandemic was linked to psychosomatic complaints. Sense of coherence explained variations in well-being, emotional exhaustion and psychosomatic complaints. Conclusion: This study highlights the importance of enhancing the health literacy of Danish school leaders, enabling them to deal effectively with complex health-related information and make informed decisions during health crises. Strengthening health literacy is crucial to promoting overall health and well-being in schools under normal circumstances, as well as navigating health crises.

Tuberculous meningitis patient pathways and delays to diagnosis in Indonesia: a retrospective cohort study

IntroductionDelays in diagnosis and treatment contribute to high mortality of tuberculous meningitis (TBM). We studied TBM patient pathways including delays to diagnosis, and their alignment with available diagnostic services in...

Latin America and the Caribbean Code Against Cancer 1st edition: Formative research on the comprehension and persuasiveness of the recommendations by the general population

BackgroundCancer prevention is the most efficient and cost-effective strategy in cancer control. One prevention strategy is giving credible, clear, and evidence-based recommendations to the individual; however, it is key that these messages are accepted and understood properly by the public. This study aimed to pilot the draft recommendations developed as part of the Latin America and the Caribbean (LAC) Code Against Cancer 1st edition, in terms of comprehension and persuasion of each message. MethodsA mixed method two-wave study, in which two versions of the messages were presented to the general population in five LAC countries. We used an ad-hoc questionnaire and interviews that followed the cognitive-pretesting methodology. ResultsFindings suggest that the messages were generally well understood, especially in Spanish speaking countries, and that the messages were generally more understandable than persuasive. We adapted and revised the recommendations based on the findings of the first Wave and held a second iteration in the Spanish speaking countries. We observed a better understanding of most messages in Wave 2. ConclusionThe LAC Code Against Cancer is a valuable tool of well understood messages for the public, with concrete actions everyone can take to prevent cancer. Further research should assess particularities of the region for further efficient dissemination of these important health messages, identify key messages for certain population groups and future interventions that strengthen health literacy in rural and less educated populations to increase behavior change.

Model of Strengthening Health Literacy and Prevention of Hypertension Based on Family Independence

Abstract&#x0D; Hypertension is often referred to as the silent killer because it is a deadly disease accompanied by early symptoms for people with hypertension. The prevalence of hypertension continues to increase sharply and it is predicted by 2025 as many as 29% of adults, but the tendency to do prevention independently is still low. Prevention of hypertension can’t be separated from the risk factors that exist in the family, including an unhealthy lifestyle. Family involvement in early detection needs to develop and modified so that every family member can reduce risk factors. The brief background of the topic and significance of the study. This study aims to collect information on the family of ability in health literacy as a solution to increase family independence in preventing hypertension. This study is used for research and development (R&amp;D), which is the first of 3 research stages planned to be completed in 3 years. The research design was cross-sectional. The study was conducted on families in Bangkalan Regency with a sample of 150 people from 4 sub-districts representing mountainous, urban, rural, and coastal areas, namely Bangkalan, Kedundung, Sukolilo, and Kokop sub-districts taken by random cluster sampling. Data was collected using questionnaires and analyzed using Partial Least Square Path Modeling. This study has obtained ethically appropriate information through the Research Ethics Committee of the Health Polytechnic of the Ministry of Health Surabaya with the number EA/940/KEPK-Poltekkes Sby/V/2022. The results show that the demographic characteristics of the family have an effect on health literacy in preventing hypertension. Families with good health literacy can increase independence in preventing hypertension. Families who achieve a high level of independence will be able to prevent hypertension. The use of digital literacy can be a solution to improve people's health literacy skills. Materials from health literacy are made simpler but right on target. Supported by more complex forms of communication such as interactive video. Application usage to advance the knowledge of patients' hypertension can increase the independence of hypertension.

Strengthening Health Literacy Through Structured Sessions for Non-Communicable Diseases in Low-Resource Settings: The Learning Nest Model.

Health literate self-management education is at stake for the prevention and management of non-communicable diseases in low resources settings and countries. Here we describe the Learning Nest in Ordinary Context (NA-CO in French, Nids d'Apprentissage en Contexte Ordinaire) aiming at the structuring of health education programs at the micro- (education sessions) and the meso-levels (adapted to context). The Learning Nest model was designed based on a combination on health literacy principles and on studies conducted with vulnerable people with non-communicable diseases. Observation of NA-CO active-learning sessions found them to be operational and relevant as they center on access, understanding, and use of health information while integrating the ordinary context of learners. The Learning Nest packages (including several adapted thematic sessions, training of trainers and development in context) were shown to be feasible and realistic in diverse locations (Reunion, Mali, Mayotte, Mauritius, Burundi). Qualitative and intervention studies have documented the potential usefulness of the Learning Nest model for context- and setting-specific health literacy interventions.

Audio Visual Education Effectivity to Increase Knowledge about Anemia in Pregnant Women

Aims: WHO reported 36.5% pregnant women in the world experienced anaemia, which 75.0% of them lived in developing countries. It included 63.5% of them who lived in Indonesia. The highest prevalence of anemic pregnancy in Jakarta province was located in North Jakarta, that related to iron deficiency and nutritional status. Boosting knowledge and educating women about pregnancy had to be done effectively in order to get optimal output. Choosing the right educational media was an essential part of the movement. Audio Visual Education (AVE) was commonly use to educate people, instead of limited resources. It stimulated two human sense, sight and hearing, which estimated could increase learning process. Method: We held a quasi-experimental study by gathering 30 pregnant women to watch AVE about anemia in pregnancy who were willing to participate and havent received any education about anemia via educational video. Exclusion criteria were being uncooperative, such as not watching the video completely and didn’t fill in pre- and posttest completely. We used purposive sampling to gather participants. There were pre and post-test ten minutes before and after intervention. We performed Wilcoxon Test to analyze the effectivity of AVE in order to increase knowledge about anemia (p&lt;0.05). Results: We found AVE could boost knowledge score in the third pregnant women statistically significant. Before intervention, average knowledge score was 56,7% which increased to 91,7% after AVE (p value=0.0001). Conclusion: This study implied AVE was an effective media to increase participant’s knowledge about anemic pregnancy in pregnant women. Strengthening health literacy through planned educational programs would improve health behavior of individual and community.

How can care managers strengthen health literacy among patients with common mental disorders? A qualitative study.

In order for persons with mental illness to be able to promote and preserve their health, sufficient knowledge about health is required. An effective means to improve the health of the patients is to strengthen their health literacy. The aim of this study was to explore how care managers work with health literacy in patients with common mental disorders to help them to better understand and manage their illness. A qualitative study was conducted, using written reports from 25 care managers regarding meetings with patients with common mental disorders in the primary care in a Swedish region. The care managers' reports were coded based on Sörensen's four dimensions for the domain "health care" and analysed deductively through systematic text condensation according to Malterud. The care managers described how they worked strategically and continuously with follow-up and wanted to be responsive to the patients' stories. They confirmed the patients' feelings with the goal of creating increased interaction, thereby involving the patients in their own care. The care managers also worked actively to provide well-balanced care at an early stage. Using various tools such as self-assessment instruments, the care manager started from the patient's basic problem, gave support and discussed strategies based on the patient's condition and situation. The care managers used multifaceted health literacy interventions. They worked in a person-centred, strategic and encouraging manner based on the patient's unique conditions, where sensitivity and adapted information were important aspects. The aim of the interventions was for the patients to become knowledgeable, gain new insights and work independently with their own health.

Physicians’ perceptions of patient participation in the myocardial infarction pathway

Myocardial infarction is an acute, frightening and life-threatening condition for patients who are affected. They need plain and simple information about the disease and the treatment, yet patient participation might be challenging in acute situations. Previous studies have shown that patient participation leads to improved patient satisfaction, cooperation with healthcare professionals and better management of the disease. Physicians have a key role in facilitating patient participation in the healthcare services. This study explores physicians’ perceptions of patient participation in the myocardial infarction pathway. In 2018 we interviewed nine experienced physicians in Norway working in different phases of the pathway. Hermeneutics was chosen as the underpinning analytical framework. Four themes illustrated patient participation in the myocardial infarction pathway. Paternalism characterised the acute phase. During hospitalisation the physicians perceived a lack of continuity in physician–patient communication. In the discharge phase, the physicians focused on strengthening health literacy. In the rehabilitation phase, dialogue and shared decision making was central to achieving treatment adherence. We found variations in the level of patient participation along the different phases of the myocardial infarction pathway. Strengthening continuity to ensure patient participation and collaboration between healthcare professionals is essential. The physicians proposed introducing checklists for patient information to enhance interprofessional collaboration and strengthen patient participation.

How Do Primary Care Organizations Rate Their Level of Organizational Health Literacy? Results of a Swiss Pilot-Study.

Primary care organizations offer a suitable setting to promote organizational health literacy (OHL) since they are a crucial interface for patients and clients. However, a clear picture on the OHL situation in primary care is lacking. The aim of this study was to assess OHL in Swiss primary care organizations by evaluating (i) how they rate their level of OHL and which improvement measures they accordingly plan (organizational level), (ii) what knowledge and attitudes among health professionals in primary care regarding OHL exist (individual level) and (iii) how teams working in general practitioners' practices and a home care service organization differ regarding OHL (organizational and individual level). The research design included an online survey (N = 74, health professionals) on the individual level and a checklist and intervention documentation (N = 10, primary care teams) on the organizational level. The study reveals a crucial demand regarding organizationally embedded OHL practices in the participating primary care teams, despite a rather comprehensive understanding of the concept. The greatest need for action was identified in strengthening health literacy of staff members, which underlines the necessity to develop interventions to systematically strengthen the health literacy of health professionals.

The guided use of an e-health tool to strengthen health literacy. A pilot study in a multicultural diabetes population in a primary care clinic in Brussels.

We aimed to investigate whether the use of an e-health tool, guided by a healthcare provider, can improve health literacy (HL) in primary care. We set up a longitudinal prospective cohort study in a primary care clinic in Brussels. Diabetes patients were invited to participate in two study consultations with a trained healthcare provider, in which an e-health tool was introduced. The Health Literacy Questionnaire (HLQ) was used to evaluate HL before (n = 59) and after intervention (n = 41). The data were analysed within SPSS, Version 26. Additionally, impressions and experiences of both patients and healthcare providers were collected throughout the different phases of the study. Patients feel significantly stronger in finding good health information after intervention (p = 0.041), with relatively stronger progress for the subgroup with weaker digital skills (p = 0.029). Participants also declare understanding health information better after intervention (p = 0.050). Specifically, the lower educated participants feel reinforced to correctly evaluate and assess health information and come closer to the skill level of the higher educated patients after intervention. The relationship with the healthcare provider was also more markedly enhanced within the group of the lower educated (p = 0.008; difference between higher and lower educated), which could strengthen self-management in the long run. The guided use of an e-health tool in primary care strengthens various patient HL skills. Most particularly the skills "the ability to find good health information" and "understand health information well enough to know what to do" are reinforced. Moreover, patient populations with lower HL, such as the lower educated and lower digitally skilled, show a greater learning potential. Our results offer further proof for the learnable and flexible nature of HL, and show that even a small e-health intervention, in a very diverse patient population, can produce significant, positive effects on HL. These results need to be considered as promising, and a motivation for further investments in more widely accessible e-health tools to further improve HL at population level and to bridge health differences.

Organizational health literacy in health care: Results from a participatory project in Germany

Abstract Background Health care facilities (i.e., hospitals, care facilities and integration assistance) play an important role in providing health-related information and strengthening health literacy (HL) of patients/clients, staff and at the organizational level. The project “Development of Health Literacy in Health Care Facilities (EwiKo)’ aims at implementing tools to promote and strengthen organizational health literacy (OHL) in health care institutions in Germany. Objectives are 1) to assess needs for strengthening OHL in pilot facilities and 2) to examine factors that are beneficial to strengthen OHL in health care facilities. Methods N = 6 pilot institutions (n = 2 hospitals, n = 2 care homes for elderly people, n = 2 facilities for people with disabilities) and their members of the “working groups on HL” filled in a self-assessment tool to assess the level of OHL, accompanied by focus group interviews (n = 6-9 persons per pilot facility). Regarding conducive and obstructive factors when implementing tools to strengthen OHL, focus group interviews (n = 6-9 persons per pilot facility) and semi-structured interviews (n = 1 coordinator per organization) were conducted. Results Results of the self-assessment tool showed a need to strengthen OHL in all types of health care facilities, particularly in the fields of action ‘training of employees in HL tools’, “communication” and ‘participatory development and testing of documents, materials and services on HL’. Results of the focus group interviews showed a special need to strengthen OHL in the area ‘HL of employees’. Beneficial factors by implementing tools to strengthen OHL are, for instance a supporting management, resources, a participatory approach and trainings by the project team. Conclusions Due to the ongoing corona pandemic and accompanying challenges (e.g., personnel resources), it is comprehensible that health care facilities emphasize a need for strengthening HL of employees.