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

Abstract

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.

Fit for Diversity: A Staff-Driven Organizational Development Process Based on the Organizational Health Literacy Responsiveness Framework

“…This is the first study to report on the Org-HLR process outside the Australian context in which it was developed. Existing literature supporting the effectiveness of health literacy responsiveness interventions is still limited (Farmanova et al, 2018). However, since the emergence of the first guides in 2006 many frameworks has been published and to some extent positively validated (Farmanova et al, 2018).…”

“…Existing literature supporting the effectiveness of health literacy responsiveness interventions is still limited (Farmanova et al, 2018). However, since the emergence of the first guides in 2006 many frameworks has been published and to some extent positively validated (Farmanova et al, 2018). The Org-HLR is one of the first frameworks developed empirically using a concept-mapping approach with health care professionals (Trezona et al, 2017).…”

“…Organizational health literacy responsiveness is "the way in which services, organizations and systems make health information and resources available and accessible to people according to health literacy strengths and limitations" (IUHPE Global Working Group on Health Literacy, 2018, p. 6). Although there are few intervention studies on organizational health literacy responsiveness, several frameworks exploring the concept are available (Farmanova, Bonneville, & Bouchard, 2018). Recently, the Organizational Health Literacy Responsiveness (Org-HLR) framework was developed, involving seven domains characterizing health literacy responsive organizations: (1) external policy and funding environment; (2) leadership and culture; (3) systems, processes, and policies; (4) access to services and programs; (5) community engagement and partnerships; (6) communication prac-tices and standards; and (7) workforce (Trezona, Dodson, & Osborne, 2017).…”

Organizational Health Literacy in Facilities for People with Disabilities: First Results of an Explorative Qualitative and Quantitative Study

“…Guides of health-literate organizations differ greatly in their scope and context of application [33]. Particularly in English-speaking countries, there are numerous guides available to strengthen OHL [23,25,29,32].…”

“…Further, skilled staff in the organizations play a decisive role in the implementation of interventions on the promotion of OHL, as they are available as a trustworthy source of information for patients and clients [18,23,27,32,33,37]. In particular, interventions are recommended that make it easier, for example, for clients as well as other stakeholders, to access and find their way to and through the organization.…”