Organizational health literacy in primary care: a type 2 hyprid effectiveness-implementation study

Abstract Background Promoting organizational health literacy (OHL) in primary care is crucial for public health, as it aligns healthcare services with patient needs and strengthens the health literacy of patients, caregivers, and professionals. For this purpose, the Swiss OHL Self-Assessment Tool for Primary Care (OHL Self-AsseT) was developed, accompanied by an implementation strategy. The aim of the current phase is to evaluate the effectiveness of the OHL Self-AsseT (organizational/professional health literacy) and implementation outcomes. Methods Using a type 2 hybrid effectiveness-implementation design, the study evaluates both the intervention effectiveness and implementation outcomes. For intervention evaluation, a quasi-experimental pre-post design is applied in 18-20 primary care teams. Data collection started in 2024 and will last until the end of 2025 through validated online questionnaires. The implementation outcomes are evaluated via an explanatory mixed-method design, oriented to Normalization Process Theory. Data of a subsample of 24-28 participants is collected via questionnaires and interviews. Results Results of 6 teams show an improvement in all 6 OHL dimensions and positive effects on strengthening leadership skills. Further qualitative implementation data show that participants reported an improved ability to identify areas that need change and were able to implement change while interacting with their management. Conclusions Based on the so far available data, the OHL Self-AsseT seems to offer practical and sustainable support for primary care teams in improving their OHL. Effectiveness data from the larger sample will be presented at the conference and is crucial before scaling the tool. Based on the validated implementation strategy, the tool can be seamlessly integrated into existing organizational development processes, fostering long-term improvements in health literacy on a large scale.