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Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia)

BACKGROUND: The need for healthcare strengthening to enhance equity is critical, requiring systematic approaches that focus on those experiencing lesser access and outcomes. This project developed and tested the Ophelia (OPtimising HEalth LIteracy and Access) approach for co-design of interventions...

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Autores principales: Beauchamp, Alison, Batterham, Roy W., Dodson, Sarity, Astbury, Brad, Elsworth, Gerald R., McPhee, Crystal, Jacobson, Jeanine, Buchbinder, Rachelle, Osborne, Richard H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5335493/
https://www.ncbi.nlm.nih.gov/pubmed/28253883
http://dx.doi.org/10.1186/s12889-017-4147-5
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author Beauchamp, Alison
Batterham, Roy W.
Dodson, Sarity
Astbury, Brad
Elsworth, Gerald R.
McPhee, Crystal
Jacobson, Jeanine
Buchbinder, Rachelle
Osborne, Richard H.
author_facet Beauchamp, Alison
Batterham, Roy W.
Dodson, Sarity
Astbury, Brad
Elsworth, Gerald R.
McPhee, Crystal
Jacobson, Jeanine
Buchbinder, Rachelle
Osborne, Richard H.
author_sort Beauchamp, Alison
collection PubMed
description BACKGROUND: The need for healthcare strengthening to enhance equity is critical, requiring systematic approaches that focus on those experiencing lesser access and outcomes. This project developed and tested the Ophelia (OPtimising HEalth LIteracy and Access) approach for co-design of interventions to improve health literacy and equity of access. Eight principles guided this development: Outcomes focused; Equity driven, Needs diagnosis, Co-design, Driven by local wisdom, Sustainable, Responsive and Systematically applied. We report the application of the Ophelia process where proof-of-concept was defined as successful application of the principles. METHODS: Nine sites were briefed on the aims of the project around health literacy, co-design and quality improvement. The sites were rural/metropolitan, small/large hospitals, community health centres or municipalities. Each site identified their own priorities for improvement; collected health literacy data using the Health Literacy Questionnaire (HLQ) within the identified priority groups; engaged staff in co-design workshops to generate ideas for improvement; developed program-logic models; and implemented their projects using Plan-Do-Study-Act (PDSA) cycles. Evaluation included assessment of impacts on organisations, practitioners and service users, and whether the principles were applied. RESULTS: Sites undertook co-design workshops involving discussion of service user needs informed by HLQ (n = 813) and interview data. Sites generated between 21 and 78 intervention ideas and then planned their selected interventions through program-logic models. Sites successfully implemented interventions and refined them progressively with PDSA cycles. Interventions generally involved one of four pathways: development of clinician skills and resources for health literacy, engagement of community volunteers to disseminate health promotion messages, direct impact on consumers’ health literacy, and redesign of existing services. Evidence of application of the principles was found in all sites. CONCLUSIONS: The Ophelia approach guided identification of health literacy issues at each participating site and the development and implementation of locally appropriate solutions. The eight principles provided a framework that allowed flexible application of the Ophelia approach and generation of a diverse set of interventions. Changes were observed at organisational, staff, and community member levels. The Ophelia approach can be used to generate health service improvements that enhance health outcomes and address inequity of access to healthcare. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-017-4147-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-53354932017-03-06 Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia) Beauchamp, Alison Batterham, Roy W. Dodson, Sarity Astbury, Brad Elsworth, Gerald R. McPhee, Crystal Jacobson, Jeanine Buchbinder, Rachelle Osborne, Richard H. BMC Public Health Research Article BACKGROUND: The need for healthcare strengthening to enhance equity is critical, requiring systematic approaches that focus on those experiencing lesser access and outcomes. This project developed and tested the Ophelia (OPtimising HEalth LIteracy and Access) approach for co-design of interventions to improve health literacy and equity of access. Eight principles guided this development: Outcomes focused; Equity driven, Needs diagnosis, Co-design, Driven by local wisdom, Sustainable, Responsive and Systematically applied. We report the application of the Ophelia process where proof-of-concept was defined as successful application of the principles. METHODS: Nine sites were briefed on the aims of the project around health literacy, co-design and quality improvement. The sites were rural/metropolitan, small/large hospitals, community health centres or municipalities. Each site identified their own priorities for improvement; collected health literacy data using the Health Literacy Questionnaire (HLQ) within the identified priority groups; engaged staff in co-design workshops to generate ideas for improvement; developed program-logic models; and implemented their projects using Plan-Do-Study-Act (PDSA) cycles. Evaluation included assessment of impacts on organisations, practitioners and service users, and whether the principles were applied. RESULTS: Sites undertook co-design workshops involving discussion of service user needs informed by HLQ (n = 813) and interview data. Sites generated between 21 and 78 intervention ideas and then planned their selected interventions through program-logic models. Sites successfully implemented interventions and refined them progressively with PDSA cycles. Interventions generally involved one of four pathways: development of clinician skills and resources for health literacy, engagement of community volunteers to disseminate health promotion messages, direct impact on consumers’ health literacy, and redesign of existing services. Evidence of application of the principles was found in all sites. CONCLUSIONS: The Ophelia approach guided identification of health literacy issues at each participating site and the development and implementation of locally appropriate solutions. The eight principles provided a framework that allowed flexible application of the Ophelia approach and generation of a diverse set of interventions. Changes were observed at organisational, staff, and community member levels. The Ophelia approach can be used to generate health service improvements that enhance health outcomes and address inequity of access to healthcare. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-017-4147-5) contains supplementary material, which is available to authorized users. BioMed Central 2017-03-03 /pmc/articles/PMC5335493/ /pubmed/28253883 http://dx.doi.org/10.1186/s12889-017-4147-5 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Beauchamp, Alison
Batterham, Roy W.
Dodson, Sarity
Astbury, Brad
Elsworth, Gerald R.
McPhee, Crystal
Jacobson, Jeanine
Buchbinder, Rachelle
Osborne, Richard H.
Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia)
title Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia)
title_full Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia)
title_fullStr Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia)
title_full_unstemmed Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia)
title_short Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia)
title_sort systematic development and implementation of interventions to optimise health literacy and access (ophelia)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5335493/
https://www.ncbi.nlm.nih.gov/pubmed/28253883
http://dx.doi.org/10.1186/s12889-017-4147-5
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