Improving organisational health literacy in diabetes care – a multisite evaluation of OHL-Act
Abstract
Background: Challenged health literacy is associated with poorer diabetes outcomes and contributes to persistent health inequalities. Organizational health literacy (OHL) focuses on how healthcare organizations can reduce complexity and support individuals with diverse health literacy needs. The OHL-Act is a participatory approach developed to strengthen OHL; however, there is limited evidence regarding its implementation across contexts, the mechanisms through which it drives change, and its effectiveness in achieving and sustaining improvements. This study aims to: 1) evaluate the reach, effectiveness, adoption, implementation, and maintenance of OHL-Act across diverse healthcare organisations, and 2) examine mechanisms of change as well as contextual facilitators and barriers influencing these implementation outcomes.
Methods: A multisite mixed-methods evaluation (2026–2028) will be conducted across hospital and municipal organizations implementing the OHL-Act in diabetes care. OHL-Act consist of three workshops engaging staff and managers in structured self-assessment and prioritization of improvement ideas. This evaluation is guided by the RE-AIM framework combined with PRISM to assess implementation processes, outcomes, and contextual influences. Data will be collected through surveys, organizational assessment, implementation logs, and qualitative interviews.
Results: The study is expected to generate evidence on the implementation of OHL-Act across healthcare settings, including insights into reach, adoption, and sustainability. It will identify key mechanisms driving organizational change and highlight facilitators and barriers influencing implementation across contexts.
Conclusions: This study is expected to contribute to the evidence on strengthening OHL in complex diabetes care. Findings may inform future strategies to support more equitable, accessible, and responsive healthcare systems.
Related
- Process evaluation of the INTENSE study aimed at improving adherence to oral diabetes and/or hypertension medication in people with type 2 diabetes
- Organisational Support for Diabetes Nursing Teams, Self‐Assessed Knowledge, and Training Willingness: A Cross‐Sectional Study
- Interventions to Enhance Organisational Health Literacy Responsiveness in Institutional and Community‐Based Settings for Children: A Systematic Scoping Review
- Using a self-assessment tool to strengthen organisational health literacy in primary care in Sweden
- Diagnostic Accuracy of Pressure Injury Staging Among Nurses: A Multisite Study Using Knowledge Assessment and Image‐Based Evaluation
BibTeX
@article{meldgaard2026improving,
title = {{Improving organisational health literacy in diabetes care – a multisite evaluation of OHL-Act}},
author = {M Meldgaard and A Aaby and Helle Maindal},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.760},
url = {https://doi.org/10.1093/eurpub/ckag169.760},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Improving organisational health literacy in diabetes care – a multisite evaluation of OHL-Act
AU - M Meldgaard
AU - A Aaby
AU - Helle Maindal
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.760
UR - https://doi.org/10.1093/eurpub/ckag169.760
AB - Background: Challenged health literacy is associated with poorer diabetes outcomes and contributes to persistent health inequalities. Organizational health literacy (OHL) focuses on how healthcare organizations can reduce complexity and support individuals with diverse health literacy needs. The OHL-Act is a participatory approach developed to strengthen OHL; however, there is limited evidence regarding its implementation across contexts, the mechanisms through which it drives change, and its effectiveness in achieving and sustaining improvements. This study aims to: 1) evaluate the reach, effectiveness, adoption, implementation, and maintenance of OHL-Act across diverse healthcare organisations, and 2) examine mechanisms of change as well as contextual facilitators and barriers influencing these implementation outcomes. Methods: A multisite mixed-methods evaluation (2026–2028) will be conducted across hospital and municipal organizations implementing the OHL-Act in diabetes care. OHL-Act consist of three workshops engaging staff and managers in structured self-assessment and prioritization of improvement ideas. This evaluation is guided by the RE-AIM framework combined with PRISM to assess implementation processes, outcomes, and contextual influences. Data will be collected through surveys, organizational assessment, implementation logs, and qualitative interviews. Results: The study is expected to generate evidence on the implementation of OHL-Act across healthcare settings, including insights into reach, adoption, and sustainability. It will identify key mechanisms driving organizational change and highlight facilitators and barriers influencing implementation across contexts. Conclusions: This study is expected to contribute to the evidence on strengthening OHL in complex diabetes care. Findings may inform future strategies to support more equitable, accessible, and responsive healthcare systems.
SN - 1101-1262
SN - 1464-360X
ER -