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Cited by 88Health Literacy and Information AccessibilityHealth Policy Implementation SciencePublic Health Policies and Education

Improving organizational capacity to address health literacy in public health: a rapid realist review

Willis, C.D., Saul, J.E., Bitz, J., Pompu, K., Best, A., Jackson, B.·2014·Public Health
DOI 10.1016/j.puhe.2014.01.014
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Abstract

Objectives Despite the growing significance of health literacy to public health, relatively little is known about how organizational capacity may be improved for planning, implementing and sustaining health literacy interventions. This study aimed to connect decision makers in a public health agency with evidence of how organizational capacity may be improved for delivering health literacy services.Study design A rapid realist review of published and grey literature was conducted by a partnership between the Public Health Agency of Canada (PHAC) and the InSource Research Group.Methods Realist review methodology attempts to understand what works for whom under what circumstances, and is characterized by its focus on strategies/interventions, contexts, mechanisms and their relationship to outcome. This review was completed in collaboration with a reference panel (comprised of a broad range of PHAC representatives) and an expert panel. Literature searching was conducted using three databases supplemented with bibliographic hand searches and articles recommended by panels. Data were extracted on key variables related to definitions, strategies/interventions associated with increased organizational capacity, contextual factors associated with success (and failure), mechanisms activated as a result of different strategies and contexts, key outcomes, and evidence cited.Results Strategies found to be associated with improved organizational capacity for delivering health literacy services may be classified into three domains: (1) government action; (2) organizational/practitioner action; and (3) partnership action. Government action includes developing policies to reinforce social norms; setting standards for education; conducting research; and measuring health literacy levels. Organizational/practitioner action relates to appropriate models of leadership (both high-level government engagement and distributed leadership). Innovative partnership action includes collaborations with media outlets, those producing electronic materials, community organizations and school-based programs. Contextual factors for success include positive leadership models, interorganizational relationships, and a culture committed to experimentation and learning. Potential mechanisms activated by strategies and contextual factors include increased visibility and recognition of health literacy efforts, enthusiasm and momentum for health literacy activities, reduced cognitive dissonance between vision and action, a sense of ownership for health literacy data, and creation of a common language and understanding.Conclusions Government initiated interventions and policies are powerful strategies by which organizational capacity to improve health literacy may be affected. Using the foundations created by the government policy environment, organizations may improve the impact of health literacy interventions through supported distributed leadership.

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  • Technological developments promoted a shift from a health care model dominated by professionals toward a patient-centered model in which patients and professionals collaborate to create a service that offers the most optimal health care solution.

    “Technological developments promoted a shift from a health care model dominated by professionals toward a patient-centered model in which patients and professionals collaborate to create a service that offers the most optimal health care solution [25].”

    From Improving the Theoretical Understanding Toward Patient-Driven Health Care Innovation Through Online Value Cocreation: Systematic Review (2020) · cites this paper as [25]

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Authors
Willis, C. D., Saul, J. E., Bitz, J., Pompu, K., Best, A., & Jackson, B.
Affiliations
  • University of British Columbia (CA)
  • First Nations Health Authority (CA)
  • Public Health Agency of Canada (CA)
Corresponding author
Willis, C.D.
ORCID
Venue
Public Health
Publisher
Elsevier BV
Published
2014-06
Volume
128
Issue
6
Pages
515-524
ISSN
0033-3506 (ISSN-L)
DOI
10.1016/j.puhe.2014.01.014
OpenAlex
W2056871293
Cited by
88
References
38
Citations by year
2026: 7 · 2025: 5 · 2024: 6 · 2023: 4 · 2022: 5 · 2021: 13 · 2020: 17 · 2019: 5 · 2018: 9 · 2017: 7 · 2016: 7 · 2015: 2 · 2014: 1
FWCI
0.96
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Public Health (publishedVersion)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Funders
  • Public Health Agency of Canada
  • National Health and Medical Research Council
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
Keywords
health literacy, organizational capacity, public health agencies, health literacy interventions, distributed leadership, inter-organizational partnerships, health policy, health literacy assessment, organizational culture, cognitive dissonance, media partnerships
MeSH terms
Canada, Humans, Public Health Administration, Capacity Building, Health Literacy

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