Future perspectives on health literacy research
High quality health literacy research during the life course will enhance evidence-based education, policy and practice. IROHLA has identified promising interventions to solve health literacy problems through the contribution of many different actors – relatives, neighbours and friends, as well as healthcare workers, other professionals and decision makers. These interventions will promote health literacy and may contribute to the reduction of health disparities in populations. We have identified several priorities for further research to strengthen the knowledge base. Some of these priorities are described below.
1. Understanding health literacy during the life course
Understanding the pathways
To break the cycle of disadvantage of people with low health literacy, we need research to improve our understanding the pathways that link health literacy to health, well-being, and participation in society in different age groups. Gaining a better view of these pathways would be valuable for developers of interventions. This would allow them to focus their efforts more specifically on potentially modifiable determinants and on groups that could benefit the most.
2. Intervention research during the life course
Intervention research among children and families
Starting early in life will be the most effective strategy to break the cycle of disadvantage among people with low health literacy.
Evaluation of E-health applications among people with low health literacy
E-health applications can be tailored to the needs of users but evaluation among people with low health literacy is scarce. The researchers of IROHLA recommend close collaboration between developers, professionals and people with low health literacy in the development and evaluation of E-health applications. IROHLA has developed questionnaires for research to develop, validate and improve innovative E-health applications. The E-health Needs Assessment Questionnaire (ENAQ) is useful to map the general needs of older adults with low health literacy regarding e-health applications. The Evaluative Questionnaire for E-health Tools (EQET) can be used to assess the suitability of e-health applications for older adults with low health literacy. Further evaluation of E-health applications in different contexts is needed. Furthermore, insight is needed in the strategies to promote maintenance of behaviour with e-health applications.
Improving person-centred care for people with mental health problems
Intervention research is needed to develop and test the effectiveness of strategies to improve patient-centred care for people with mental health problems, especially among youth with low health literacy and mental health problems. Empowerment of people with limited health literacy (e.g., decision making, enabling self-management) in combination with capacity building of professionals are important core elements for further evaluations.
Improvement of the quality of teaching and learning
There is a strong need in Europe for sustainable quality improvement in the education of health professional students to tackle health literacy problems. IROHLA has developed a health literacy communication training for professionals and they have recommended to customize this training for education. An important ambition is to increase the competences of health professional students in Europe to deal effectively with the health literacy needs of diverse populations using the results of IROHLA and other projects, taking into account student and tutors needs and promoting innovative teaching and learning approaches.
Implementation of interventions
The implementation of comprehensive interventions is a dynamic process with different actors and different target groups, e.g. individuals, families, health professionals, communities and health care systems. Improving our understanding of the implementation process is needed to promote health literacy with a comprehensive approach. Important questions are: “How are interventions implemented and under which circumstances?” and “What is the impact of the implementation process of the outcomes of interventions?”.
In 2016 members of the IROHLA consortium will continue their research to assess the impact of environmental health literacy interventions on the development of policies in health care institutions. This knowledge will contribute to more successful implementation of environmental health literacy interventions.