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BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Development of the Organisational Health Literacy Responsiveness (Org-HLR) self-assessment tool and process

Authors: Anita Trezona, Sarity Dodson, Richard H. Osborne

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

The World Health Organization describes health literacy as a critical determinant of health and driver of citizen empowerment and health equity. Several studies have shown that health literacy is associated with a range of socioeconomic factors including educational attainment, financial position and ethnicity. The complexity of the health system influences how well a person is able to engage with information and services. Health organisations can empower the populations they serve and address inequity by ensuring they are health literacy responsive. The aim of this study was to develop the Organisational Health Literacy Responsiveness self-assessment tool (Org-HLR Tool), and an assessment process to support organisations with application of the tool.

Methods

A co-design workshop with health and social service professionals was undertaken to inform the structure of the tool and assessment process. Participants critiqued existing self-assessment tools and discussed the likely utility of the data they generate. A review of widely used organisational performance assessment tools informed the structure and self-assessment process. The Organisational Health Literacy Responsiveness (Org-HLR) Framework (with seven domains/24 sub-domains) provided the structure for the assessment dimensions of the tool. The performance indicators were drawn from raw data collected during development of the Org-HLR Framework.

Results

Twenty-two professionals participated in the workshop. Based on the feedback provided and a review of existing tools, a multi-stage, group-based assessment process for implementing the Org-HLR Tool was developed. The assessment process was divided into three parts; i) reflection; ii) self-rating; and iii) priority setting, each supported by a corresponding tool. The self-rating tool, consistent with the Org-HLR Framework, was divided into: External policy and funding environment; Leadership and culture; Systems, processes and policies; Access to services and programs; Community engagement and partnerships; Communication practices and standards; Workforce. Each of these had 1 to 5 sub-dimensions (24 in total), and 135 performance indicators.

Conclusions

The Org-HLR Tool and assessment process were developed to address a gap in available tools to support organisations to assess their health literacy responsiveness, and prioritise and plan their quality improvement activities. The tool is currently in the field for further utility and acceptability testing.
Appendix
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Literature
1.
2.
3.
4.
5.
6.
Herndon JB, Chaney M, Carden D. Health literacy and emergency department out-comes: a systematic review. Ann Emerg Med. 2011;57(4):334–45.CrossRefPubMed
7.
Wolf MS, Gazmararian JA, Baker DW. Health literacy and functional health status among older adults. Arch Intern Med. 2005;165(17):1946–52.CrossRefPubMed
8.
Tokuda Y, Doba N, Butler JP, Paasche-Orlow MK. Health literacy and physical and psychological wellbeing in Japanese adults. Patient Educ Couns. 2009;75(3):411–7.CrossRefPubMed
9.
10.
van der Heide I, Uiters E, Rademakers J, Struijs JN, Schuit AJ, Baan CA. Associations among health literacy, diabetes knowledge, and self-management behavior in adults with diabetes: results of a dutch cross-sectional study. J Health Commun. 2014;19(Suppl 2):115–31.CrossRefPubMed
11.
Paasche-Orlow M, Wolf M. The causal pathways linking health literacy to health outcomes. Am J Health Behav. 2007;31(1):S19–26.CrossRefPubMed
12.
13.
World Health Organization, editor. Shanghai Declaration on Promoting Health in the 2030 Agenda for Sustainable Development. 9th Global Conference on Health Promotion. Shanghai; Geneva: World Health Organization; 2016.
14.
Trezona A, Dodson S, Osborne RH. Development of the Organisational Health Literacy Responsiveness (Org-HLR) Framework in collaboration with health and social services professionals. BMC Health Serv Res. 2017;17(1):513.CrossRefPubMedPubMedCentral
15.
Brach C, Keller D, Hernandez LM, Baur C, Parker R, Dreyer B, et al. Ten attributes of health literate health care Organisations: discussion paper. Washington: Institute of Medicine; 2012. Accessed 27 Oct 2013
16.
Parker RM, Hernandez LM. What makes an organization health literate? J Health Commun. 2012;17(5):624–7.CrossRefPubMed
17.
Kripalani S, Wallston K, Cavanaugh K, Osborn CY, Mulvaney S, McDougald S, et al. Measures to assess a health-literate organization. Washington: Vanderbilt Center for Effective Health Communication; 2014.
18.
Dodson S, Good S, Osborne RH. Health literacy toolkit for low and middle income countries: a series of information sheets to empower communities to strengthen health systems. New Delhi: World Health Organization; 2015.
19.
Wolf JA. Organization development in healthcare : conversations on research and strategies. Bingley: Emerald Group Publishing; 2011.CrossRef
20.
Ritchie L, Dale BG. Self-assessment using the business excellence model: a study of practice and process. Int J Prod Econ. 2000;66(3):241–54.CrossRef
21.
Miller R, Bedney B, Guenther-Grey C. Assessing organizational capacity to deliver HIV prevention services collaboratively: Tales from the field. Health Educ Behav. 2003;30(5):582–600.CrossRefPubMed
22.
Ford MW. Baldrige assessment and organizational learning: the need for change management. Qual Manag J. 2001;8(3):9–25.CrossRef
23.
Fountain M. The target assessment model as an international standard for self-assessment. Total Qual Manag. 1998;9(4&5):S95–S9.CrossRef
24.
Trenerry B, Paradies Y. Organizational assessment: an overlooked approach to managing diversity and addressing racism in the workplace. J Divers Manage. 2012;7(1):11–26.
25.
26.
DeWalt D, McNeill J. Integrating Health Literacy with Health Care Performance Measurement. Washington: Institute of Medicine; 2013.
27.
World Health Organization Regional Office for Europe. Health Literacy: The Solid Facts. Copenhagen: World Health Organization; 2013.
28.
Thomacos N, Zazryn, T. Enliven Organisational Health Literacy Self-assessment Resource. Melbourne: Enliven & School of Primary Health Care, Monash University; 2013.
29.
Ministry of Health. Health literacy review: a guide. Wellington: Ministry of Health; 2015.
30.
Dietscher C, Pelikan J. Health-literate hospitals and healthcare organizations - results from an Austrian Feasability study on the self-assessment of organizational health literacy in hospitals. In: Schaeffer D, Pelikan J, editors. Health literacy. Bern: Hogrefe; 2017.
31.
32.
Trochim WM. An introduction to concept mapping for planning and evaluation. Eval Program Plann. 1989;12(1):1–16.CrossRef
33.
Trochim WM, Milstein B, Wood BJ, Jackson S, Pressler V. Setting objectives for community and systems change: an application of concept mapping for planning a statewide health improvement initiative. Health Promot Pract. 2004;5(1):8–19. discussion 0CrossRefPubMed
34.
Risisky D, Hogan VK, Kane M, Burt B, Dove C, Payton M. Concept mapping as a tool to engage a community in health disparity identification. Ethn Dis. 2008;18:77–83.PubMed
35.
Rosas SR, Ridings JW. The use of concept mapping in measurement development and evaluation: application and future directions. Eval Program Plann. 2017;60:265–76.CrossRefPubMed
36.
Norgaard O, Furstrand D, Klokker L, Karnoe A, Batterham R, Kayser L, et al. The e-health literacy framework: a conceptual framework for characterizing e-health users and their interaction with e- health systems. Knowl Manage E-Learn. 2015;7(4):522–40.
37.
van Randeraad-van der Zee CH, Beurskens A, Swinkels R, Pool J, Batterham RW, Osborne RH, et al. The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping. Qual Life Res. 2016;25:1219–25.CrossRefPubMed
38.
Vaughn LM, Jacquez F, McLinden D. The use of concept mapping to identify community-driven intervention strategies for physical and mental health. Health Promot Pract. 2013;14(5):675–85.CrossRefPubMed
39.
40.
41.
MacColl Institute for Healthcare Innovation. Assessment of Chronic Illness Care, Version 3.5. 2000.
42.
Agency for Healthcare Research and Quality. Primary Care Health Literacy Assessment. Rockville: Agency for Healthcare Research Quality, 2010.
43.
Baldrige Performance Excellence Program. The metrology of organizational performance: how Baldrige standards have become the common language for organizational excellence around the world. United States: Baldrige Performance Excellence Program; 2015.
44.
Nabitz U, Klazinga N, Walburg J. The EFQM excellence model: European and Dutch experiences with the EFQM approach in health care. Int J Qual Health Care. 2000;12(3):191–201.CrossRefPubMed
45.
46.
47.
48.
Harvey J, Kindervatter S, Woods A. The gender audit handbook: a tool for organizational self-assessment and transformation. Washington: InterAction; 2010.
49.
Department of Health. ASM prepare - express: active service model practice review planning and reflection tool. Melbourne: Victorian Government; 2010.
50.
Anderson DL. Organization development: the process of leading organizational change. 2nd ed. California: Sage Publications; 2012.
51.
Blazey ML. Insights into organisational self-assessments. Qual Prog. 1998;31(10):47–52.
Metadata
Title
Development of the Organisational Health Literacy Responsiveness (Org-HLR) self-assessment tool and process
Authors
Anita Trezona
Sarity Dodson
Richard H. Osborne
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3499-6

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