Organizational Health Literacy in Schools: Concept Development for Health-Literate Schools.

(1) Background: Health literacy is considered a personal asset, important for meeting health-related challenges of the 21st century. Measures for assisting students' health literacy development and improving health outcomes can be implemented in the school setting. First, this is achieved by providing students with learning opportunities to foster their personal health literacy, thus supporting behavior change. Second, it is achieved by measures at the organizational level promoting social change within the proximal and distal environment and supporting the school in becoming more health-literate. The latter approach is rooted in the concept of organizational health literacy, which comprises a settings-based approach aiming at changing organizational conditions to enhance health literacy of relevant stakeholders. The HeLit-Schools project aims to develop the concept of health-literate schools, describing aspects that need to be addressed for a school to become a health-literate organization. (2) Method: The concept development builds on existing concepts of organizational health literacy and its adaptation to the school setting. (3) Results: The adaptation results in the HeLit-Schools concept describing a health-literate school with eight standards. Each standard depicts an area within the school organization that can be developed for fostering health literacy of school-related persons. (4) Conclusions: The HeLit-Schools concept offers an approach to organizational development for sustainably strengthening health literacy.

Health Literacy in Portugal: Results of the Health Literacy Population Survey Project 2019-2021.

Health literacy entails the knowledge, motivation, and competencies to access, understand, appraise, and apply health information in order to make judgments and decisions in everyday life concerning health care, disease prevention, and health promotion to maintain or improve quality of life throughout the life course. It has become an essential concept in public health. It is considered a modifiable determinant of health decisions, health behaviors, health, and healthcare outcomes. Prior studies suggest highly variable levels of health literacy across European countries. Assessing and monitoring health literacy is critical to support interventions and policies to improve health literacy. This study aimed to describe the process of adaptation to Portugal of the short-form version of the Health Literacy Survey (HLS19-Q12) from the Health Literacy Population Survey Project 2019-2021, also establishing the health literacy levels in the Portuguese population. The sample comprised 1247 valid cases. The survey consisted of a brief questionnaire on the determinants of health literacy, plus the HLS19-Q12 questionnaire and the specific health literacies packages on digital health literacy, navigational health literacy, and vaccination health literacy. The results suggest that 7 out of 10 people in Portugal (mainland) have high health literacy levels and support the results of other studies concerning the main socioeconomic determinants of general health literacy. Furthermore, the results suggest that "navigation in the health system" tasks are the most challenging tasks regarding specific health literacies. The overall data suggest the HLS19-Q12 as a feasible measure to assess health literacy in the Portuguese population. Thus, it can be used in Portugal to assess the population's needs and monitor and evaluate policies and initiatives to promote health literacy by addressing its societal, environmental, personal, and situational modifiable determinant factors.

Health Literacy in Austria: Interventions and Research.

This report provides an overview of Austria's approaches to improve population health literacy (HL). The report suggests: a) research can trigger health policy responses to improve HL; b) linking HL improvement to other reform agendas can boost effectiveness, and c) coordination is required for continuously and systematically working towards better HL. Examples of strategic thematic approaches and interventions - especially in the fields of communication in healthcare, health information products, and organizational HL responsiveness - are provided, and Austria's role in preparing the next European HL survey, HLS19, is briefly described.

How can the functioning and effectiveness of networks in the settings approach of health promotion be understood, achieved and researched?

Networks in health promotion (HP) have, after the launch of WHO's Ottawa Charter [(World Health Organization (WHO) (eds). (1986) Ottawa Charter on Health Promotion. Towards A New Public Health. World Health Organization, Geneva], become a widespread tool to disseminate HP especially in conjunction with the settings approach. Despite their allegedly high importance for HP practice and more than two decades of experiences with networking so far, a sound theoretical basis to support effective planning, formation, coordination and strategy development for networks in the settings approach of HP (HPSN) is still widely missing. Brößkamp-Stone's multi-facetted interorganizational network assessment framework (2004) provides a starting point but falls short of specifying the outcomes that can be reasonably expected from the specific network type of HPSN, and the specific processes/strategies and structures that are needed to achieve them. Based on outcome models in HP, on social, managerial and health science theories of networks, settings and organizations, a sociological systems theory approach and the capacity approach in HP, this article points out why existing approaches to studying networks are insufficient for HPSN, what can be understood by their functioning and effectiveness, what preconditions there are for HPSN effectiveness and how an HPSN functioning and effectiveness framework proposed on these grounds can be used for researching networks in practice, drawing on experiences from the 'Project on an Internationally Comparative Evaluation Study of the International Network of Health Promoting Hospitals and Health Services' (PRICES-HPH), which was coordinated by the WHO Collaborating Centre for Health Promotion in Hospitals and Health Services (Vienna WHO-CC) from 2008 to 2012.

Health promotion implementation capacities in hospitals matter: results from the PRICES-HPH study.

In this article, organizational implementation capacities are discussed as facilitators for hospital health promotion (HP) activities, based on data from 159 sampled hospitals of the PRICES-HPH study. PRICES-HPH is a cross-sectional evaluation study of the International Network of Health Promoting Hospitals and Health Services (HPH-Network) and was conducted from 2008 to 2012. Hospitals applying elaborated HP implementation capacities such as 'regular health promotion projects and organization-wide programs', 'established health promotion management systems' or the 'integration of health promotion in existing quality management systems' have better HP activity scores as compared with hospitals that implement HP on the basis of occasional projects only. Organizational capacities are associated with considerably higher chances for the successful implementation of a multiplicity of different HP activities in hospitals. The results add further evidence to the importance of capacity building in hospital HP.

Improving Organizational Health Literacy in Extracurricular Youth Work Settings.

Although most health literacy (HL) interventions in Europe focus on the enhancement of individual competences and primarily address health care, this article describes a novel approach to improving the HL friendliness of extracurricular youth work in Austria. Accordingly, the "Vienna Concept of Health-Literate Hospitals and Healthcare Organizations (V-HLO)" was transferred to extracurricular youth work for the first time. This article first gives a concise overview of the project, then outlines the interaction between the project development and the evaluation, and finally summarizes the main project outcomes and results. The project outcomes and the results indicate that the concept of organizational HL, in particular the V-HLO, could be transferred from the health care setting to the extracurricular youth work setting; yet data indicate that different priorities are relevant and different tools are needed. Although quality management is an important partner to implement the V-HLO in hospitals, more informal and flexible structures are required for an extracurricular youth work setting. The successful transfer of the V-HLO to the extracurricular youth work setting illustrates that the V-HLO has potential in varied settings beyond health care. [Health Literacy Research and Practice. 2017;1(4):e233-e238.].

[Why should and how can hospitals improve their organizational health literacy?]. / Warum sollten und wie können Krankenhäuser ihre organisationale Gesundheitskompetenz verbessern?

In late modern "multi-option" and "health" societies, health literacy (HL), understood as a specific competence, is considered necessary to successfully deal with the multitude of health relevant decisions and tasks to be taken every day. The concept has been used in the US, primarily in healthcare, to research the consequences of HL on the outcome of treatment specifically in patients with limited HL. In this context, it became evident that HL has to be understood as a relational or contextual concept. That is, the adequacy of HL does not only depend on personal HL, but equally on the demands organizations put on their users. This understanding of HL opened the road to measure not only individual HL, but also the HL sensitivity of organizations, i.e. organizational HL, and to use targeted measures to improve it. The ten attributes of a health-literate healthcare organization, as defined by the US Institute of Medicine, are a first systematic attempt to use this strategy in healthcare. In the meantime, the strategy has been used in other settings as well. Using experiences from health-promoting hospitals and the quality movement in healthcare, the authors develop this approach further into the comprehensive Vienna concept of the health-literate hospital, which considers all stakeholders and tasks of the hospital which are relevant for HL. A self-assessment tool was developed and tested as a basic instrument for developing a health-literate hospital. By doing so, hospitals are empowered to make a contribution to the promotion of HL as an important societal task.

Organizational capacities for health promotion implementation: results from an international hospital study.

In this article, organizational structures in hospitals are discussed as possible capacities for hospital health promotion (HP) implementation, based on data from the PRICES-HPH study. PRICES-HPH is a cross-sectional evaluation study of the International Network of Health Promoting Hospitals & Health Services (HPH-Network) and was conducted in 2008-2012. Data from 159 acute care hospitals were used in the analysis. Twelve organizational structures, which were denoted as possible organizational health promotion capacities in previous literature, were tested for their association with certain strategic HP implementation approaches. Four organizational structures were significantly (p = 0.05) associated with one or more elaborate and comprehensive strategic HP implementation approaches: (1) a health promotion specific quality assessment routine; (2) an official hospital health promotion team; (3) a fulltime hospital health promotion coordinator; and (4) officially documented health promotion policies, strategies or standards. The results add further evidence to the importance of organizational capacity structures for hospital health promotion and identify four tangible structures as likely candidates for organizational HP capacities in hospitals.

Learning in networks: individual teacher learning versus organizational learning in a regional health-promoting schools network.

To change a school into a health-promoting organization, organizational learning is required. The evaluation of an Austrian regional health-promoting schools network provides qualitative data on the views of the different stakeholders on learning in this network (steering group, network coordinator and representatives of the network schools; n = 26). Through thematic analysis and deep-structure analyses, the following three forms of learning in the network were identified: (A) individual learning through input offered by the network coordination, (B) individual learning between the network schools, i.e. through exchange between the representatives of different schools and (C) learning within the participating schools, i.e. organizational learning. Learning between (B) or within the participating schools (C) seems to be rare in the network; concepts of individual teacher learning are prevalent. Difficulties detected relating to the transfer of information from the network to the member schools included barriers to organizational learning such as the lack of collaboration, coordination and communication in the network schools, which might be effects of the school system in which the observed network is located. To ensure connectivity of the information offered by the network, more emphasis should be put on linking health promotion to school development and the core processes of schools.