How Do Primary Care Organizations Rate Their Level of Organizational Health Literacy? Results of a Swiss Pilot-Study

Primary care organizations offer a suitable setting to promote organizational health literacy (OHL) since they are a crucial interface for patients and clients. However, a clear picture on the OHL situation in primary care is lacking. The aim of this study was to assess OHL in Swiss primary care organizations by evaluating (i) how they rate their level of OHL and which improvement measures they accordingly plan (organizational level), (ii) what knowledge and attitudes among health professionals in primary care regarding OHL exist (individual level) and (iii) how teams working in general practitioners' practices and a home care service organization differ regarding OHL (organizational and individual level). The research design included an online survey (N = 74, health professionals) on the individual level and a checklist and intervention documentation (N = 10, primary care teams) on the organizational level. The study reveals a crucial demand regarding organizationally embedded OHL practices in the participating primary care teams, despite a rather comprehensive understanding of the concept. The greatest need for action was identified in strengthening health literacy of staff members, which underlines the necessity to develop interventions to systematically strengthen the health literacy of health professionals.

Health Professionals' Experience with the First Implementation of the Organizational Health Literacy Self-Assessment Tool for Primary Care (OHL Self-AsseT)-A Qualitative Reflexive Thematic Analysis

Organizational health literacy (OHL) is crucial for public health, in turn health care organizations play vital roles in improving populations' health literacy. Therefore, the aim of this qualitative study was to explore how the organizational health literacy self-assessment tool (OHL Self-AsseT) was implemented, used, and understood by primary care teams from a network of general practices and a Home Care Service Organization in Zurich, Switzerland. Reflexive thematic analysis with a constructivist orientation was used to analyze data from 19 interviews pre- and post-OHL Self-AsseT use. Normalization Process Theory supported structuring of inductively developed themes. Findings show that the participants experienced working with the OHL Self-AsseT meaningful, as it helped with "Addressing OHL construction sites" so that they could "build momentum for change". The experience of "Succeeding together in construction" led to a "feeling of team-efficacy during change". Practical use of the tool and/or discussions about OHL led to a growing conceptual understanding, which was described as "Using a construction plan-making sense of ongoing OHL activities". To conclude, the OHL Self-AsseT encouraged teams to initiate change, led to greater team-efficacy and supported the construction of OHL. Improved implementation strategies will support this intervention's scale-up as a base for effectiveness testing.