Dealing with health literacy at the organisational level, French translation and adaptation of the Vienna health literate organisation self-assessment tool

Abstract

Background Efforts to address health literacy should favour a system-based approach with the dual aim both of fostering the material conditions and creating a work culture inside health care organisations that makes it easier for people to use information. The Vienna Health Literate Organisation (V-HLO) self-assessment tool is a German-speaking questionnaire for quality managers of health care organisations. Its objective is to provide a diagnostic of the strengths and weaknesses of the organisation in terms of health literacy. Our goal was to translate and culturally adapt this questionnaire for the French-speaking part of Belgium. Methods We followed the Translation, Review, Adjudication, Pretesting, and Documentation (TRAPD) team model for cross-cultural translation of questionnaires. We used cognitive interviews with quality experts to pre-test the translation. Results Cognitive interviews allowed us to improve the translation by removing certain ambiguities, providing contextual clarifications or rephrasing some items in such a way as to render them more culturally appropriate. Local experts generally judged the tool to be relevant and applicable to their context. The insight gained with regard to their cognitive process when completing the V-HLO allowed us to identify possible barriers to the adoption of the tool (such as difficulties in considering staff literacy as a relevant target for the tool, fear of overwhelming staff, a feeling that some items fell outside the scope of health literacy and lack of attention for integration of services with primary care) and could contribute to the future development of the tool. Conclusion We translated and adapted the V-HLO self-assessment tool for French. The French version of the V-HLO will now be implemented in our local context to assess whether it can make it easier for people to deal with the complexities of health care organisations. Electronic supplementary material The online version of this article (10.1186/s12913-019-3955-y) contains supplementary material, which is available to authorized users.

Review of Organizational Health Literacy Practice at Health Care Centers: Outcomes, Barriers and Facilitators

“…Health literacy tools, particularly AHRQ, VHLO, and HLHO-10, provide best practices and evidence-based recommendations to enhance OHL capacities [ 9 , 37 , 40 , 41 ]; they help build a business case and include facilitating quality improvement processes for OHL. The studies included in the systematic review shows that all tools are potentially validated measurement tools for screening and evaluating OHL, and are implemented according to their quality improvement characteristics and HL dimensions [ 28 ].…”

“…It includes 9 attributes, that are assessed both from the point of view of patients and from the perspective of health providers and professionals, to globally check the prospective actions to improve OHL and the friendliness of health care organizations [ 42 , 51 , 52 ]. The C-CAT benchmark has been focused on five out of the nine dimensions of OHL: the engagement of health providers and professionals in the promotion of OHL, the organizational commitment toward the improvement of HL, the methods, and tools used to assess HL, the involvement of the specific communities (included patients, informal caregivers, educational institutions, and municipalities) to improve HL, and the assessment of the initiatives directed at the improvement of OHL [ 21 , 28 ]. This tool is employed to improve HL in the health care context based on two categories.…”

“…The scientific studies have focused most of its attention on patient treatment; however, the role of OHL in empowering patient’s self- management support and communication has been overlooked [ 27 ]. Likewise, limited work has been done to identify barriers and facilitators that influence quality improvement in OHL [ 9 , 28 ]. Absent such information, health systems may be unable to evaluate whether OHL-related attributes and guidelines have been implemented effectively or to identify the characteristics and outcomes of its environment most in need of improvement [ 29 ].…”

The Vienna self-assessment questionnaire: a usable tool towards more health-literate hospitals? Explorative case studies in three hospitals in Belgium

“…We used the French translated and validated version of the V-HLO (V-HLO-fr) [ 17 ]. In our study, standard 7 (‘improving the health literacy of the staff themselves’) is deleted from the questionnaire, which reduces the number of sub-standards to 20 and items to 149.…”

“…A recent report by a Belgian healthcare knowledge centre sets the benchmarks for a national policy and underlines the need to act at the level of healthcare institutions, among other things through the use of self-assessment tools [ 16 ]. Because of the successful evaluation of the V-HLO and its international dissemination opportunity, we decided to translate and adapt this tool for the Belgian French-speaking context, what was described in a previous publication [ 17 ] to then explore its feasibility in Belgian hospitals.…”