Multi-staged development and pilot testing of a self-assessment tool for organizational health literacy.

BACKGROUND: Until now a comprehensive, consensus-based tool that can be used by a variety of health care organizations for assessing their organizational health literacy (OHL) is not available. Therefore, we aimed to develop and test a literature- and consensus-based self-assessment tool. METHODS: The study is based on a scoping review that was previously published by the authors. For the development of the self-assessment tool, the criteria identified in the literature were synthesized with criteria gained through group discussions with representatives of different types of health care organizations (N = 27) all based in Hamburg (Germany). Consensus on the criteria was reached by conducting a Delphi process (N = 22). A review by the project's patient advisory council was included in the process. The self-assessment tool was converted into an online tool and refined by a pretest. Finally, the online survey was piloted (N = 53) and the reliability and item loadings for each scale were analyzed. RESULTS: In total, 77 criteria (items) characterizing a health literate health care organization were developed and grouped into five main categories (scales): (1) "easy access and navigation", (2) "integration, prioritization, and dissemination of OHL", (3) "qualification, quality management, evaluation, and needs assessment", (4) "communication with target groups", and (5) "involvement and support of target groups". The results of the online survey showed that the tool is suitable for assessing an organization's status quo on OHL. The psychometric analysis showed good to excellent internal consistency. Item analyses of the developed self-assessment tool was satisfactory. CONCLUSIONS: We were able to define a set of 77 items to characterize OHL, which were integrated into a new, comprehensive, and consensus-based self-assessment tool to identify areas for improvement. We found evidence that the self-assessment tool, based on the identified criteria, consists of the assumed five scales. Further research should analyze the validity of the self-assessment tool on a higher detail level.

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

BACKGROUND: Organizational health literacy (OHL) aims to respond to the health literacy needs of patients by improving health information and services and making them easier to understand, access, and apply. This scoping review primarily maps criteria characterizing health literate health care organizations. Secondary outcomes are the concepts and terminologies underlying these criteria as well as instruments to measure them. METHODS: The review was carried out following the JBI Manual on scoping reviews. The databases CINAHL, Cochrane Library, JSTOR, PsycINFO, PubMed, Web of Science Core Collection, and Wiley Online Library were searched in July 2020. Three researchers screened the records and extracted the data. The results were synthesized systematically and descriptively. RESULTS: The literature search resulted in 639 records. After removing duplicates, screening by title and abstract, and assessing full-texts for eligibility, the scoping review included 60 publications. Criteria for OHL were extracted and assigned to six main categories (with 25 subcategories). The most prevalent topic of organizational health literacy refers to communication with service users. Exemplary criteria regarding this main category are the education and information of service users, work on easy-to-understand written materials as well as oral exchange, and verifying understanding. The six main categories were defined as 1) communication with service users; 2) easy access & navigation; 3) integration & prioritization of OHL; 4) assessments & organizational development; 5) engagement & support of service users, and 6) information & qualification of staff. The criteria were based on various concepts and terminologies. Terminologies were categorized into four conceptual clusters: 1) health literacy in various social contexts; 2) health literate health care organization; 3) organizational behavior, and 4) communication in health care. 17 different assessment tools and instruments were identified. Only some of the toolkits and instruments were validated or tested in feasibility studies. CONCLUSIONS: Organizational health literacy includes a significant number of distinct organizational criteria. The terminologies used in the OHL literature are heterogeneous based on a variety of concepts. A comprehensive, consensus-based conceptual framework on OHL is missing.

Job demands and resources perceived by hybrid working employees in German public administration: a qualitative study.

BACKGROUND: Hybrid working arrangements that combine remote and office work are on the rise. Although hybrid work has been associated with mental health benefits in employees, challenges in the transformation to hybrid persist particularly in public administration organizations which have been connected to a pronounced culture of presence and inadequate technical infrastructure. Further evidence on the link between hybrid working conditions and employee health is needed. To support the establishment of healthy hybrid working conditions, this study aims to identify employees' job demands, resources and support needs in public administration. METHODS: Semi-structured interviews were conducted with N = 13 employees who work hybrid in public administration organizations in Northern Germany between February and May 2023. Interviewees were asked about their perceived job demands, resources, and support needs in hybrid work. The data was analyzed in a deductive-inductive approach of qualitative content analysis, primarily supported by the job demands-resources model as a theoretical framework. RESULTS: Several job demands, e.g., an increase in work and meetings, and resources such as personal freedom and responsibility, were identified in the context of hybrid work. A multitude of the reported job resources and demands relate to work organization and social relationships. The results disclose discrepancies between participants' experiences of job demands and resources, underlining the subjectivity of employees' perceptions of hybrid working conditions. Interviewees' support needs for hybrid work also varied, encompassing structural-level aspects such as increased acceptance and promotion of hybrid work in the organization as well as behavioral-level aspects, for instance, strategies and self-discipline for boundaries and structure. CONCLUSIONS: This study provides a first comprehensive overview of the job demands, resources and support needs in hybrid work in public administration. This study builds an important basis for further research to understand the impact of hybrid working conditions on health-related employee outcomes. The identified support needs provide a valuable point of reference for health-promoting hybrid working conditions which public administration employers should begin establishing as early as possible in the ongoing transition to hybrid work.