Organisational health literacy in healthcare in Europe: a content analysis to explore stakeholders perspectives for supporting the adoption of effective strategies and interventions

BACKGROUND: Organisational Health Literacy (OHL) refers to the capacity of healthcare organisations to enable people to find, understand, appraise, and use health information and services equitably. Although interest in OHL has grown across Europe, the degree to which healthcare organisations adopt and assess OHL remains uneven. OBJECTIVE: This study explored stakeholders' perspectives on factors that facilitate or hinder the uptake of OHL strategies and assessments within healthcare organisations in Europe. METHODS: Semi‑structured interviews and surveys were conducted with stakeholders from six European countries within the JA PreventNCD initiative. Data were analysed using qualitative content analysis to identify macro‑ and micro‑themes related to OHL adoption and assessment. A SWOT analysis was conducted to provide a framework for discussing the factors that facilitate and hinder the adoption of OHL in healthcare organisations. RESULTS: Across countries, stakeholders highlighted several overarching themes: the importance of leadership commitment, staff training, and integrating OHL into organisational processes; the need to involve patients and communities; and key strategies to support OHL assessments-communicating their added value, securing managerial or authority‑level incentives, and using practical tools. A lack of awareness of OHL, scarce resources and management support, and overly complex tools, actors and steps to secure commitment were also identified as issues to address. CONCLUSIONS: Stakeholders across diverse health systems emphasised that strengthening OHL requires coordinated organisational action rather than isolated activities. Prioritising leadership engagement, embedding OHL into quality improvement structures, and supporting staff through training and accessible tools are crucial to creating sustainable OHL‑responsive environments. These findings provide actionable insights for designing and implementing OHL strategies and assessments in European healthcare organisations considering facilitating and hindering factors for their adoption.