To address the issue of health literacy, policy makers can help to improve health literacy levels by incorporating health literacy in all policies for healthcare and healthy ageing. Professionals can take into account that especially older people, people with low social economic status, low literacy and people who are in a stressfull situation, need extra attention to adapt communication to a lower level of health literacy.
In the IROHLA project an intervention model was developed by consultation with experts, brainstorming sessions and an extensive review of the literature. This model may help understand the mechanisms that might underlie effective health literacy interventions targeted at older adults with low health literacy, aiming at both the individual and their context, and the health professionals and the health system he/she works in. Further, a large number of theories potentially relevant to reducing health problems in older adults with low health literacy were identified. By reviewing these theories, potentially modifiable constructs for each target group (older adults, professionals and their contexts) were selected. For example, increasing awareness, knowledge, motivation and skills of professionals were identified as important components of health literacy interventions. You can find a detailed description of the IROHLA model here.
Comprehensive approaches are more effective
The IROHLA model (see figure) is a comprehensive approach because it includes several components and refers to all stakeholders involved. Comprehensive approaches in prevention and healthcare have been shown to be more effective compared to single interventions. For instance, when it comes to reducing obesity, successful interventions tend to include activities on healthy nutrition and physical activities, involve peers and their families, while at the same time taxing unhealthy products. The selection of intervention components can be based on theories and evidence about the underlying mechanisms or pathways. Different pathways or mechanisms may explain the relationship between health literacy interventions and outcomes. In the IROHLA, project best practices and evidence-based approaches were identified in the health, social and private sector. A combination of these practices and approaches, joined in a comprehensive intervention, may reduce health literacy problems.
National health literacy policies, part of patient safety, quality programmes and healthy ageing strategies
To guide the health sector, ministries of health can produce national health literacy policies or strategies, like several countries in the EU have already done. Health literacy can also be part of national public health programmes, patient safety and quality programmes as well as healthy ageing strategies. Clinical and public health guidelines should include strategies to deal with people who find it difficult to understand and use health information. It is important that actions reinforce each other and that the focus on individual skills of older people and health professionals is accompanied by actions that make the health systems more health literate. Such a comprehensive approach will give the best results. We analised different health literacy policies and you can find them here.