Developing core outcome domains for evaluation of organizational health literacy interventions

Abstract Background Organizational health literacy responsiveness (OHLR) is the ability of organizations to respond to user health literacy needs. Research addressing outcome measures of OHLR interventions is scarce and most instruments assess the concept of OHLR at the whole-organizational level, making it difficult to compare different improvement strategies. This study aimed to develop core outcome domains (CODs) for OHLR interventions to facilitate methodological stringency in evaluations. Methods The study identified and categorized OHLR outcomes into domains through a narrative literature review and a content mapping. To reach consensus on CODs, a digital Delphi process was performed among experts within OHLR. Participants ranked the domains and suggested improvements regarding content. Results Based on the literature review, 383 OHLR outcomes were identified in nine publications. Content mapping allowed us to categorize these into 26 proposed outcome domains. The Delphi process involved 24 experts and resulted in consensus on 15 CODs under five headings: 1) Organizational change, leadership, and management, 2) Workforce responsiveness, 3) Person-centered care and user involvement, 4) Access and navigation, and 5) Partnerships and transitions. Conclusions The identified CODs may contribute greatly to the stringency of future evaluations of OHLR interventions. They enhance comparisons between methodologically or contextually related interventions and facilitate their assessment against the complete concept of OHLR. It is suggested that OHLR CODs be used as a guiding scaffold in planning, evaluation and reporting of OHLR initiatives. Key messages • By systematic identification and consensus-based prioritization, 15 core outcome domains were identified representing the heartwood of organizational health literacy responsiveness. • Core outcome domains have the potential to improve stringency and comparability of organizational health literacy responsiveness intervention evaluation.