Facilitators for implementing health literacy interventions

What facilitates implementation of interventions and guidelines on health literacy?

Changing practice or policy is a dynamic and complex process. To implement health literacy interventions or guidelines with success, it is important to understand the factors that may influence implementation in a variety of local contexts.

The list below collects the identified facilitators for implementing interventions or guidelines in healthcare settings. The type of facilitators people will face in their work in prevention, treatment and care of patients will vary. The following list based on implemention research is developed in the context of the IROHLA project which is looking for improving the health literacy of senior population. Being aware of the facilitators or barriers might enhance the identification of barriers or overcoming those barriers to promote successful implementation. This is relevant for professionals involved in the implementation process and developers of health literacy interventions.

The list includes the facilitators for implementing health literacy interventions or guidelines on four levels:

  1. content
  2. patient
  3. professional
  4. organisational

Before starting the implementation of interventions or guidelines, the identification of the specific barriers and facilitators in the local context is needed to design an appropriate and effective implementation strategy.  Co-creation can be a valuable strategy to achieve a successful implementation process. Regular meetings, joint reflection and learning are considered to be crucial for long-term collaboration of implementers of an interventions.

Below you will find the list and references. You can also download the PDF of the list: Download PDF here


Patient level

Professional level


  • Brouwers M, Kho ME, Browman GP, Cluzeau F, Feder G, Fervers B, Hanna S, Makarski J on behalf of the AGREE Next Steps Consortium. AGREE II: Advancing guideline development, reporting and evaluation in healthcare. Can Med Assoc J. Dec 2010, 182:E839-842; doi: 10.1503/cmaj.090449
  • Gagliardi AR, Marshall C, Huckson S, James R, Moore V.Developing a checklist for guideline implementation planning: review and synthesis of guideline development and implementation advice Gagliardi et al. Implementation Science (2015) 10:19 DOI 10.1186/s13012-015-0205-5
  • Holger J et al. Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise CMAJ DOI:10.1503/cmaj.131237
  • Kastner M, Estey E, Hayden L, Chatterjee A, Grudniewicz A, Graham ID, Bhattacharyya O. The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives. Kastner et al. BMC Family Practice 2014, 15:19
  • Koot JAR, Pos S. Barriers and Facilitators for Implementation of Clinical Guidelines, report for the Dutch Institute of Quality of Health Care, 2011
  • Peters MAJ, Harmsen M, Laurant MGH, Wensing M. Ruimte voor verandering? Knelpunten en mogelijkheden voor verandering in de patiëntenzorg [Room for improvement? Barriers to and facilitators for improvement of patient care]. Nijmegen: Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, 2002
  • Colon-Emeric CS, Lekan D, Utley-Smith Q, Ammarell N, Bailey D, Corazzini K, L. Piven M, A. Anderson R. Barriers to and Facilitators of Clinical Practice Guideline Use in Nursing Homes, J Am Geriatr Soc 55:1404–1409, 2007
  • Schinckus L, Van den Broucke S, Housiaux M. Implementation Fidelity of Diabetes Self management Education Programs: A Systematic Review, The Diabetes Literacy project supported by grant FP7-Health-2012-Innovation-1/306186
  • Van Daele T, Van Audenhove Ch, Herman D, Van den Bergh O, Van den Broucke. Empowerment implementation: enhancing fidelity and adaptation in a psycho-educational intervention, Health Promotion International, Advance Access published 19.12.2012
  • Van den Branden S, Van den Broucke S, Leroy R, Declerck D, Hoppenbrouwers, K. Evaluating the Implementation Fidelity of a Multicomponent Intervention for Oral Health Promotion in Preschool Children, Society for Prevention Research 2013, DOI 10.1007/s11121-013-0425-3


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