Performing an Organizational Health Literacy Assessment in a Shelter Serving People with Mental Illness

Abstract

Background: Health literacy research and practice are constantly evolving. Recent inquiry has highlighted the burdensome literacy demands faced by people with serious mental illness (SMI). Systems, organizational operations, and structures can play a role in decreasing literacy demand, thereby reducing unnecessary challenges for people with SMI. Brief Description of Activity: An organizational health literacy assessment was conducted to explore literacy demands in one mental health shelter and revealed best practice action steps for improving the literacy environment. Implementation: The assessment included an exploration of the shelter environment using The Health Literacy Environment Activity Packet, First Impressions & Walking Interview, and a commonly used shelter document using the Simple Measure of Gobbledygook (SMOG), Suitability Assessment of Materials (SAM), and Centers for Disease Control and Prevention (CDC) Index. Results: The literacy demands of the shelter environment and a frequently used document exceeded the literacy skills of people with SMI. Environment assessment revealed environmental facilitators (e.g., welcoming atmosphere) and barriers (e.g., unclear signage). Document assessment also revealed facilitating factors and barriers. SMOG scores ranged from 11.25 to 11.80 (median: 11.38), meaning 11th to 12th grade-level reading skills are required to understand, use, and take action on the document's content. A SAM score of 50% (adequate) and a CDC Index score of 42.1 (revise and improve) reveal materials contain both facilitating factors (e.g., chunked sections) and barriers (e.g., jargon, mismatched graphics) to use. Lessons Learned: The mismatch between system demands and the literacy skills of people with SMI is more profound than that of the general United States population. Organizational health literacy assessments are achievable and useful for both immediate and long-term action aimed at understanding and improving the organizational health literacy of mental health spaces. Further work is needed to explore the role of behavioral health services in addressing the institutional and programmatic literacy demands that inhibit treatment and recovery. [ HLRP: Health Literacy Research and Practice . 2022;6(3):e167–e174. ] Plain Language Summary: An organizational health literacy assessment reveals how system demands can be changed to better serve intended users. Engaging in mental health, recovery, and treatment services requires complex literacy skills. Generally, the U.S. adult population does not have the skills to meet such demands, and this is especially true among public mental health service users.

Development of Tools to Assess Vaccine Literacy: A Scoping Review and Future Perspectives

“…Improving organizational VL is crucial for increasing vaccination rates, as healthcare organizations play a vital role in providing trustworthy and accessible information to the community. Specific instruments to evaluate organizational HL capacities have already been created and applied [106,107], It should be done the same for organizational VL, which should be the subject of dedicated research.…”

Perspectives in the Development of Tools to Assess Vaccine Literacy

“…Improving organizational VL is crucial for increasing vaccination rates, as healthcare organizations play a vital role in providing trustworthy and accessible information to the community. Specific instruments to evaluate organizational HL capacities have already been created and applied [100,101]. It should be performed the same way for organizational VL, which should be the subject of dedicated research.…”

Organizational Health Literacy as a Tool for Health Equity: Application in a High-Risk Infant Follow-Up Program

“…At least 88 percent of adults in the U.S. do not have the health literacy skills necessary to navigate the healthcare system and promote their well-being [7]. This mismatch between individual skills and healthcare system demands results in poor individual health outcomes, inefficiencies in healthcare services, and increased healthcare costs [9][10][11][12]. Poor organizational health literacy is another structural barrier that exacerbates child health inequities defined by systems barriers (e.g., racism, ableism, sexism, racial residential segregation) that largely persist across time [13].…”

“…Some research has demonstrated the importance of such assessment for organizational change to promote health equity [12,34,35]. The approach can incorporate multiple relevant systems frameworks to focus on organizational change, thereby reducing patient burden [31].…”

“…Such an assessment involves exploring health and health-related information and environments (e.g., institutional or organizational settings) to determine where patient and family burden can be reduced (i.e., ease of understanding and performing of health-related tasks or actions). Assessment produces data that can suggest changes to materials, interactions, websites, signage, processes, and spaces in clinics, hospitals, and beyond [12,[36][37][38][39].…”