Can Integrating Health Literacy into the Patient-centered Medical Home Help us Weather the Perfect Storm?

Ridpath, Jessica; Larson, Eric B.; Greene, Sarah M.

doi:10.1007/s11606-011-1964-6

Cited by 13 publications

(8 citation statements)

References 41 publications

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“…51 Others have previously equated OHL with PCC 99 and suggested integrating health literacy into patient-centered models of care. 100 Based on this, we make a recommendation that actions related to improving OHL be included under the umbrella of all organizational changes centered on PCC.…”

Section: Discussionmentioning

confidence: 99%

Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues

Farmanova

Bonneville

Bouchard

2018

INQUIRY

144

145

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Organizational health literacy is described as an organization-wide effort to transform organization and delivery of care and services to make it easier for people to navigate, understand, and use information and services to take care of their health. Several health literacy guides have been developed to assist healthcare organizations with this effort, but their content has not been systematically reviewed to understand the scope and practical implications of this transformation. The objective of this study was to review (1) theories and frameworks that inform the concept of organizational health literacy, (2) the attributes of organizational health literacy as described in the guides, (3) the evidence for the effectiveness of the guides, and (4) the barriers and facilitators to implementing organizational health literacy. Drawing on a metanarrative review method, 48 publications were reviewed, of which 15 dealt with the theories and operational frameworks, 20 presented health literacy guides, and 13 addressed guided implementation of organizational health literacy. Seven theories and 9 operational frameworks have been identified. Six health literacy dimensions and 9 quality-improvement characteristics were reviewed for each health literacy guide. Evidence about the effectiveness of health literacy guides is limited at this time, but experiences with the guides were positive. Thirteen key barriers (conceived also as facilitators) were identified. Further development of organizational health literacy requires a strong and a clear connection between its vision and operationalization as an implementation strategy to patient-centered care. For many organizations, becoming health literate will require multiple, simultaneous, and radical changes. Organizational health literacy has to make sense from clinical and financial perspectives in order for organizations to embark on such transformative journey.

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Section: Discussionmentioning

confidence: 99%

Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues

Farmanova

Bonneville

Bouchard

2018

INQUIRY

144

145

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“…Structural changes are required, such as new information systems needed to link patients with decision aids and other resources, redesigned models of office care, and restructured reimbursement schemes. 42 Systems must move toward stronger support of interprofessional collaboration and teamwork. France Légaré and colleagues recently developed and validated a conceptual model of shared decision making that accounts for teamwork.…”

Section: Physicianmentioning

confidence: 99%

Patients, Providers, And Systems Need To Acquire A Specific Set Of Competencies To Achieve Truly Patient-Centered Care

2013

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Studies show that patients want to be more involved in their own health care. Yet insufficient attention has been paid to the specific competencies of both patients and providers that are needed to optimize such patient engagement and shared decision making. In this article we address the knowledge, skills, and attitudes that patients, physicians, and health care systems require to effectively engage patients in their health care. For example, many patient-physician interactions still follow the traditional office visit format, in which the patient is passive, trusting, and compliant. We recommend imaginative models for redesigned office care, restructured reimbursement schemes, and increased support services for patients and professionals. We present three clinical scenarios to illustrate how these competencies must work together. We conclude that effective shared decision making takes time to deliver proficiently and that among other measures, policy makers must change payment models to focus on value and support education and discussion of competencies for a modern health care system.

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“…The trend in implementation of the concept is toward a broader definition and interpretation of what constitutes a dental home, making measurement of the concept more complex. Recommendations have called for the integration of related areas of research like quality of care and health literacy . Further blurring of the boundaries for the concept is caused by labeling some innovative approaches to address the dental access problem, such as care coordinators, teledentistry, and integration of oral health into primary care, as dental home initiatives .…”

Section: Introductionmentioning

confidence: 99%

Development and testing of a patient‐centered dental home assessment for low‐income families

Rozier

White

Wang

et al. 2019

J Public Health Dent

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Objectives The purpose of this study was to develop an instrument in English (ENG) and Spanish (SPA) for use in assessing perceptions of dental home characteristics among low‐income adults. Methods An expert panel selected 21 items from a pool of 81 items mapped to domains in the American Academy of Pediatrics’ medical home. Pilot testing with mothers (n = 795) of children in Early Head Start (EHS) resulted in an expanded 36‐item scale, which was field‐tested in interviews with ENG‐ (NENG = 665) and SPA‐speakers (NSPA = 116). An exploratory factor analysis of 23 usable items was carried out in an EHS reference group (NENG‐EHS = 272). The selected model was evaluated by confirmatory factor analysis (CFA) in two other subgroups (NENG‐NonEHS = 393; NSPA = 116). We tested measurement and structural invariances using a multiple‐group approach. Known‐groups validity was examined by testing factor mean differences between two groups defined by whether or not the mother used a single dental office. Results A three‐factor CFA model with 10 items was retained for its close fit for all three subgroups. Invariance tests found the two ENG subgroups to be homogenous and were combined. Several item and factor parameters in the SPA group differed from the combined ENG group. The proposed dental home measure demonstrated good known‐group validity in that people who used the same dental office reported better dental care experiences. Conclusions An instrument to measure the dental home concept among low‐income adults was developed with three domains (accessible‐comprehensive, compassionate, and health literate care) that demonstrated good validity and reliability.

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Can Integrating Health Literacy into the Patient-centered Medical Home Help us Weather the Perfect Storm?

Cited by 13 publications

References 41 publications

Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues

Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues

Patients, Providers, And Systems Need To Acquire A Specific Set Of Competencies To Achieve Truly Patient-Centered Care

Development and testing of a patient‐centered dental home assessment for low‐income families

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