Factors influencing implementation of organizational health literacy: a realist review

Abstract

PurposeHealthcare systems are increasing in complexity, and to ensure people can use the system effectively, health organizations are increasingly interested in how to take an organizational health literacy (OHL) approach. OHL is a relatively new concept, and there is little evidence about how to successfully implement organizational health literacy interventions and frameworks. This study, a literature review, aims to explore the operationalization of OHL.Design/methodology/approachA realist literature review, using a systems lens, was undertaken to examine how and why the operationalization of OHL contributed to changes in OHL and why interventions were more effective in some contexts than others. Initial scoping was followed by a formal literature search of Medline, CINAHL plus, Web of Science, Scopus, Embase and PsychINFO for original peer-reviewed publications evaluating OHL interventions until March, 2018.FindingsThe search strategy yielded 174 publications; 17 of these were included in the review. Accreditation, policy drivers, executive leadership and cultures of quality improvement provided the context for effective OHL interventions. The dominant mechanisms influencing implementation of OHL interventions included staff knowledge of OHL, internal health literacy expertise, shared responsibility and a systematic approach to implementation.Research limitations/implicationsThis study outlines what contexts and mechanisms are required to achieve particular outcomes in OHL operationalization. The context in which OHL implementation occurs is critical, as is the sequence of implementation.Originality/valueHealth services seeking to implement OHL need to understand these mechanisms so they can successfully operationalize OHL. This study advances the concept of OHL operationalization by contributing to the theory underpinning successful implementation of OHL.

Outcomes and Critical Factors for Successful Implementation of Organizational Health Literacy Interventions: A Scoping Review

“…(3) intermediate organizational outcomes showed evidence of embedding of OHL into policies and structures, staff training, and interventions to improve screening, communication and patient engagement [25][26][27][30][31][32][33]41,42]. This review thus indicates a growing awareness of how to achieve sustainable improvement on various OHL-domains, and supports the findings in recent reviews by Zanobini et al (2020) [18] and Meggetto et al (2020) [51].…”

Which criteria characterize a health literate health care organization? – a scoping review on organizational health literacy

“…Meggetto et al [ 34 ] identified 19 different terms to describe OHL, the three most frequent terms being health system health literacy , organizational health literacy , and health literacy practice/s . They observed that different terms overlap in content, but aim at different levels or contexts and concluded an interdependence between the terms and concepts: “Within health system health literacy sits OHL, and within this sits health literacy practice” [ 34 ].…”

“…Furthermore, comprehensive and current information on the criteria’s underlying concepts and terminologies, and on the instruments to measure these criteria, is expandable. Only a few studies investigated theories and concepts [ 30 ] and terminologies [ 34 ] of OHL. Both studies did not relate to the variety of criteria that characterize HLHCOs.…”

What About the Environment? How the Physical Activity–Related Health Competence Model Can Benefit From Health Literacy Research

“…Accordingly, the scientific discussion on the relevance of the environment has gained momentum (35)(36)(37). For instance, the research activities have yielded the construct of organizational health literacy as a beneficial characteristic of institutions or systems supporting people to navigate, understand, and use information and services to take care of their health (34,38,39). The considerations of the environment also permeated the action plans of several countries (40), which provide national efforts with an adequate framework for health promotion.…”