This paper adds to the discussion on interpretive phenomenology and helps inform readers of its use as a research methodology.

Organisational Health Literacy (OHL)-interventions are needed to overcome health inequality. OHL-interventions have successfully identified communication barriers at the organisational level, but evidence is limited on the extent to which this leads to sustainable organisational change. This study aims to assess the implementation fidelity, moderators (barriers and facilitators), and long-term impact of OHL-interventions in hospitals in Ireland and The Netherlands. We used a longitudinal mixed-methods approach to assess two similar OHL-interventions in one Irish and three Dutch hospitals. The OHL-interventions concerned the improvement of navigation and implementation of health literacy-friendly communication throughout organisations. Participants were 24 hospital employees and 40 older adults who use hospital services. At six, eight, and eighteen months, we assessed the level of implementation, barriers and facilitators, and impact through questionnaires and in-depth semi-structured interviews. After older adults and professionals had identified a number of communication problems, we found that professionals had successfully implemented OHL-interventions to promote navigation and comprehensible communication. Limited resources and variation in organisational structures and procedures were perceived as barriers to implementation. The participation of service users, leadership support, and a stepwise implementation of interventions were perceived to facilitate implementation. In the long term, the OHL-interventions led to system-wide improvements, as shown by better embedding of health literacy policies, enhanced patient engagement, provision of plain language training and comprehensible information. Findings were similar for the two countries. Embedded OHL-interventions resulted in sustainable and system-wide health literacy changes in all four hospitals. Following implementation, OHL-interventions have the potential to promote health equity and empowerment among health service users.

This training has potential for wider application in education and practice in Europe.

Children aged 8–12 years took 723 photographs representing well‐being. Another group of children categorised the photographs, identified what was missing and discussed their inter‐relationships. The largest categories were ‘people I love the most (friends)’ (23.2%), ‘activities’ (18%), ‘food and drink’ (17.2%) and ‘animals/pets’ (12.8%). Children reported that the categories were all related and could be subsumed into the general category ‘the way I live’, reflecting their holistic integrationist perspective on well‐being which in turn mirrors the whole child perspective of the Irish National Children's Strategy. The usefulness and limitations of this approach to working with children are discussed. Copyright © 2005 National Children's Bureau.

PurposeThis paper presents an exploration of parents', teachers' and childrens' perspectives on children's understanding of well being with the aim of illuminating and comparing the conceptualisation of well being from these three perspectives. MethodologyThe participatory method developed to undertake this study stems from our adaption of the 'draw and write' technique, with children taking photographs rather than drawing and participating in data analysis. Children aged 8 12 years took 723 photographs representing well being, while a second set of children grouped the photographs into categories. A third set organised these categories, developing and illustrating through schema the pattern of relationships between categories. This process was repeated for parent and teacher groups drawing on the photographs taken by the children. FindingsSixsmith et al. Children's, Parents' and Teachers' Perceptions of Child Well being.In Press, Health Education, Vol. 107, 2007. 3 Differences emerged between parents and teachers and children and adults. Parents provided a more detailed conceptualisation than teachers. Children included pets where adults perceived school as more important in children's well being. The identification of the differing perspectives between children and adults suggests that this approach has enabled children to illuminate their own unique perspective on well being. It also demonstrates that children can express complex understandings of abstract concepts. Practical ImplicationsThe findings reinforce the need to gain children's perspectives rather than relying on adult perceptions of children's perspectives, in order to inform quality service, practice and policy developments.

The promotion of health literacy is critical to active and informed participation in health promotion, disease prevention, and health care. This article reports on a rapid review of the evidence concerning effective strategies for improving health literacy. This review was undertaken as part of a series of evidence reviews commissioned by the European Centre for Disease Prevention and Control through the Translating Health Communications Project. The authors searched a range of electronic databases and identified six evidence reviews published between 2000 and 2011. A narrative synthesis of the findings was then conducted. The majority of the published research originated in the United States, and the studies reviewed mainly focused on functional health literacy interventions that occurred in clinical settings. Considerable gaps in the evidence exist regarding the most effective population-level health literacy interventions, particularly with regard to communicable diseases. There is a paucity of intervention studies conducted on this topic in Europe. Implications of the findings for improving population health literacy on the prevention and control of communicable diseases in Europe are considered.

This paper describes the needs assessment phase of a mental health promotion programme for rural communities in Ireland. As part of a larger study encompassing four rural communities, a cross-sectional study of the mental health beliefs and perceptions of 1014 people was carried out. Employing a combination of interviewer-administered questionnaire and the vignette method, the needs assessment explores the levels of awareness, current practices, attitudes and stigma concerning depression and suicide among a randomly selected quota sample of community members. Lower levels of awareness, less confidence in dealing with mental health issues, negative attitudes to help-seeking and social stigma emerge as particular issues for men and the under 40 age group. Women were found to have more positive attitudes generally, were more likely to use informal social support networks and were more open about discussing mental health matters. The predominant interpretation of the depression vignette was to view it as a mental health problem with good prospects for recovery given appropriate help. Social relationships, negative thinking patterns and social stresses were perceived as being particularly important in explaining the origins of depression. The implications of the findings for planning the intervention phase of the project are considered.

BackgroundConceptualizing health literacy as a relational concept, which involves how individuals interact with complex health and social systems, requires a greater understanding of the context of people's health experiences.ObjectivesTo describe individuals’ experiences of accessing, understanding, appraising and applying health information; explore the barriers and facilitators to using these skills; and to describe the experience of information exchange in health consultations.DesignA longitudinal qualitative methodology with thematic analysis of interviews was used. Health literacy levels were assessed using the HLS‐EU‐47–Item Questionnaire. Findings are presented from the first round of data collection.Setting and participantsTwenty‐six participants purposefully selected from a CVD risk reduction programme at three separate time points.ResultsFour key themes identified: using health literacy capacities for managing health; psychological and structural factors that impact on these capacities; and the relationship quality with the health‐care provider (HCP). Although limited health literacy was prevalent across the sample (65%), all individuals were very proactive in attempting to utilize health literacy skills. Findings emphasize the importance of contextual factors such as the quality of communication with the health‐care provider, perceptions of control, attitudes to family medical history, navigating structural barriers and being supported in managing treatment and medication side‐effects.Discussion and ConclusionFindings are relevant for health‐care providers in order to enhance the patient‐provider relationship and to ensure optimum health outcomes for all individuals regardless of health literacy levels.