Outcomes and critical factors for successful implementation of organizational health literacy interventions: A scoping review

Abstract

Organizational health literacy (OHL)-interventions can reduce inequality and demands in health care encountered by patients. However, an overview of their impact and critical factors for organization-wide implementation is lacking. The aim of this scoping review is to summarize the evidence on: (1) the outcomes of OHL-interventions at patient, professional and organizational lev-els; and (2) the factors and strategies that affect implementation and outcomes of OHL-interven-tions. We reviewed empirical studies following the five-stage framework of Arksey and O’Malley. The databases Scopus, PubMed, PsychInfo and CINAHL were searched from 1-1-2010 to 31-12-2019, focusing on OHL-interventions using terms related to “health literacy”, “health care organi-zation” and “intervention characteristics”. After a full-text review, we selected 24 descriptive stu-dies. Of these, 23 studies reported health literacy problems in relation to OHL-assessment tools. Nine out of thirteen studies reported that the use of interventions resulted in positive changes on OHL-domains regarding comprehensible communication, professionals’ competencies and prac-tices, and strategic organizational changes. Organization-wide OHL-interventions resulted in some improvement of patient outcomes but evidence was scarce. Critical factors for organization-wide implementation of OHL-interventions were leadership support, top-down and bottom-up ap-proaches, a change champion, and staff commitment. Organization-wide interventions lead to more positive change on OHL-domains, but evidence regarding OHL-outcomes needs strengthening.