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Symposium: Organisational health literacy – system-level health literacy response approaches for health care services working with non-communicable diseases.

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  • Anna Sofia Elisabeth Aaby
  • Jürgen Pelikan, Gesundheit Österreich GnbH, Austria
  • Helle Terkildsen Maindal
  • Nanna Husted Jensen
  • Peter Nowak, Gesundheit Österreich GmbH (Austrian Public Health Institute), Vienna, Austria., Austria
  • Eva Leuprecht, Gesundheit Österreich GmbH (Austrian Public Health Institute), Vienna, Austria., Austria
  • Christina Dietscher, Austrian Ministry of Health , Austria
General objectives
This symposium will:
1. Increase awareness of organizational health literacy (OHL) and health literate health care organizations (HLO).
2. Present experiences with the development and use of frameworks and tools to assess OHL in health care organisations.
3. Exchange local level experiences regarding health literacy challenges in NCD prevention and care.
4. Discuss opportunities and challenges regarding the use of an OHL/ HLO approach to a health system-level HL response focusing on NCD prevention and care.
Proposed format
1. Health literacy and non-communicable diseases in Europe. (10 mins)
This and the next presentation will scope the rest of the symposium.
2. The evolving concept of organizational health literacy / health literate organizations. (10 mins)
3. From the Vienna Concept and Self-Assessment Tool to an international adapted instrument on measuring organizational health literacy in hospitals (10 mins)
4. Organizational Health Literacy Responsiveness – Making organizations fit for diversity (10 mins)
5. The Conversational Health Literacy Assessment Tool (CHAT) - preliminary results from an evaluation (10 mins)
6. Audience discussions
a. Questions and answers to/from the presenters (10 mins)
b. Exchange of experience regarding major organisational health literacy challenges focusing on NCD prevention and care (15 mins)
c. Discussion of the strengths and weaknesses of presented OHL frameworks and tools in relation to the identified challenges (15 mins)
Conference theme and sub-themes
The symposium aligns with the theme - Building Health Literate Societies – by focusing on institutional health literacy responsiveness as a mean to embrace the population gradient of knowledge, motivation and competences when planning, carrying out and evaluating services.
The symposium will mainly address conference sub-theme 5 – Organizational Health Literacy and sub-theme 6 – Non-communicable diseases - a societal burden.
Presentation abstracts
Abstract presentation 1. Health literacy and non-communicable diseases in Europe
Professor, PhD MPH Helle Terkildsen Maindal

What is known? Based on large population surveys in Denmark, people with NCD’s report more difficulties than the general population in HL related-competences, and the specific diagnosis affects the association.
The above is evident in people with single conditions and especially people with multimorbidity.

What is needed? Prevention, care and rehabilitation of NCDs relies heavily on the patients active health management and abilities to find, understand and use information, navigate the health system, communicate with caretakers and take decisions regarding health. The health system alone cannot meet the challenges regarding individual health literacy, since they involve a palette of different competences acquired throughout a life course. However, health care organisations can work to better accommodate people with diverse health literacy strengths and challenges, thus improving their OHL.

Abstract presentation 2. The evolving concept of organizational health literacy / health literate organizations
Professor em., PhD Jürgen M. Pelikan

The Why. A considerable proportion of patients have limited HL which has detrimental effects on use and outcomes of health care. Furthermore, through it’s social gradient HL contributes to the health gap. This was first demonstrated in the US but later confirmed by research in Europe and Asia.

The What. To deal with patients with low HL first single interventions were implemented in the US: testing HL of patients, improving information materials, training of health professionals, and improving navigation systems in health care services. Later a whole systems approach was propagated by IOM with the publication of Ten Attributes of a Health Literate Health Care Organization by Brach et al. This lead to the development of the HLO/OHL concept and beyond for settings like cities, schools, workplaces etc.

The How. Measurement of the status quo is a prerequisite for systematic and sustainable organizational development. Therefore, different tools and interventions have been constructed to measure OHL or to improve specific aspects of OHL. Debate and research is emerging on the problems of implementing holistic OHL.

Abstract presentation 3: From the Vienna Concept and Self-Assessment Tool to an international adapted instrument on measuring organizational health literacy in hospitals
Professor em., PhD Jürgen M. Pelikan, Dr. Peter Nowak, Mag. Eva Leuprecht MA, Dr. Christina Dietscher

The Vienna concept took up the Ten Attributes of IOM, and related these to the settings approach of health promotion and to quality management. Following ISQUA rules 9 standards with 22 sub-standards and 160 indicators were developed and piloted in 9 Austrian hospitals. The concept and tool has now been translated and piloted several countries.
An international working group brought researchers together and adapted an international version of the tool for systematic testing in different countries. The results will be used by the Action Network for Measuring Population and Organizational Health Literacy (M-POHL) of the European Health Information Initiative (EHII) of WHO-Europe.

Abstract presentation 4: Organizational Health Literacy Responsiveness – Making organizations fit for diversity
MD, PhD fellow Anna Aaby

HLO make it easier for people to navigate, understand, and use information and services to take care of their health. We have investigated the development of a comprehensive local strategy on organizational HL responsiveness in a municipal rehabilitation unit in Denmark. ‘The Organizational Health Literacy Responsiveness Framework’ (Org-HLR) describes HLOs within 7 domains. During 3 workshops, we used the appertaining guide and tools to allow staff and management within the rehabilitation unit to reflect, self-assess, develop and prioritize ideas for OHL improvement.
Our results confirm the Org-HLR’s ability to guide the development of a context-sensitive multi-level long-term action plan with realistic goals OHL improvements. The bottom-up co-creational strategy supported ownership and motivation increasing the likelihood of successful implementation.

Abstract presentation 5: The Conversational Health Literacy Assessment Tool (CHAT) - preliminary results from an evaluation
Research Assistant Nanna Husted Jensen

The Conversational Health-Literacy Assessment Tool (CHAT) is a structure for client-provider communications designed to identify individual enablers and barriers related to HL. We have piloted CHAT in four municipal NCD rehabilitation teams as part of an organizational communication strategy to better identify client needs. Our preliminary results based on qualitative interviews with health care providers indicate CHAT as a useful, adjustable, feasible, and easy to apply systematic framework for identifying HL enablers and barriers. CHAT is a promising simple tool for systematic individual health literacy needs assessment within the client-provider consultations guiding the content of individual care plans.

Original languageEnglish
Publication yearMar 2019
Publication statusPublished - Mar 2019
Event4th European Health Literacy Conference 14-15 March 2019, Dublin. -
Duration: 14 Mar 201915 Mar 2019

Conference

Conference4th European Health Literacy Conference 14-15 March 2019, Dublin.
Period14/03/201915/03/2019

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