The Health Literacy in Pregnancy (HeLP) Program Study Protocol: Development of an Antenatal Care Intervention Using the Ophelia Process

Defining, assessing, and implementing organizational health literacy: barriers, facilitators, and tools - a systematic review

BACKGROUND

Organizational health literacy (OHL) is increasingly recognized as a fundamental aspect of high-quality healthcare delivery, focusing on organizations' roles in enabling patients to access, understand, and use health information effectively. This systematic review synthesizes current research on OHL, focusing on its definitions, assessment tools, implemented practices, outcomes, and the factors influencing successful OHL integration within healthcare settings.

METHODS

Guided by PRISMA and following a predefined registered protocol (PROSPERO 2024:CRD42024537425), this systematic review analyzed studies from six key databases, using targeted keywords associated with OHL. Eligibility criteria isolated research on OHL tools, practices, and outcomes in healthcare settings. Independent reviewers conducted study selection, data extraction, and bias risk analysis. Systematic quality assessment and data extraction were performed to thoroughly evaluate OHL's impact on healthcare.

RESULTS

This systematic review identified 62 articles, published between 2010 and 2024, from 15 different countries. A notable share (30.6%) aimed to develop, validate, and pilot context-sensitive OHL assessment tools. Other studies included qualitative (24.1%), descriptive (14.6%), case studies (11.29%), cross-sectional (8.06%), mixed methods (8.06%), and quantitative (3.25%) approaches, investigating factors promoting and impeding OHL outcomes. The results highlight a 54.1% increase in studies during the COVID-19 pandemic compared to the pre-pandemic period.

CONCLUSION

OHL is instrumental in advancing healthcare systems towards greater accessibility and patient-centeredness. Nevertheless, overcoming the identified implementation barriers is crucial for realizing OHL's full potential in enhancing healthcare equity and efficiency. Strategic efforts are needed to foster organizational support, adapt structural practices, and allocate necessary resources for OHL initiatives to enhance healthcare.

The post-discharge coping difficulty of puerperal women in a middle and low-income tourist city during the COVID-19 pandemic

BACKGROUND

Since the coronavirus disease 2019 (COVID-19) pandemic outbreak, the incidence of mental health problems in perinatal women has been high, and particularly prominent in China which was the first country affected by COVID-19. This paper aims to investigate the current situation and the related factors of maternal coping difficulties after discharge during COVID-19.

METHODS

General information questionnaires (the Perinatal Maternal Health Literacy Scale, Postpartum Social Support Scale and Post-Discharge Coping Difficulty Scale-New Mother Form) were used to investigate 226 puerperal women in the third week of puerperium. The influencing factors were analyzed by single factor analysis, correlation and multiple linear regression.

RESULTS

The total score of coping difficulties after discharge was 48.92 ± 12.05. At the third week after delivery, the scores of health literacy and social support were 21.34 ± 5.18 and 47.96 ± 12.71. There were negative correlations among health literacy, social support and coping difficulties after discharge (r = -0.34, r = -0.38, P < 0.001). Primipara, family income, health literacy and social support were the main factors influencing maternal coping difficulties after discharge.

CONCLUSION

During the COVID-19 pandemic, puerperal women in a low- and middle-income city had moderate coping difficulties after discharge and were affected by many factors. To meet the different needs of parturients and improve their psychological coping ability, medical staff should perform adequate assessment of social resources relevant to parturients and their families when they are discharged, so they can smoothly adapt to the role of mothers.

Application of the optimizing health literacy and access (Ophelia) process in partnership with a refugee community in Australia: Study protocol

Refugees experience health inequities resulting from multiple barriers and difficulties in accessing and engaging with services. A health literacy development approach can be used to understand health literacy strengths, needs, and preferences to build equitable access to services and information. This protocol details an adaptation of the Ophelia (Optimizing Health Literacy and Access) process to ensure authentic engagement of all stakeholders to generate culturally appropriate, needed, wanted and implementable multisectoral solutions among a former refugee community in Melbourne, Australia. The Health Literacy Questionnaire (HLQ), widely applied around the world in different population groups, including refugees, is usually the quantitative needs assessment tool of the Ophelia process. This protocol outlines an approach tailored to the context, literacy, and health literacy needs of former refugees. This project will engage a refugee settlement agency and a former refugee community (Karen people origin from Myanmar also formerly knowns as Burma) in codesign from inception. A needs assessment will identify health literacy strengths, needs, and preferences, basic demographic data and service engagement of the Karen community. This community will be engaged and interviewed using a semi-structured interview based on the Conversational Health Literacy and Assessment Tool (CHAT) will cover supportive professional and personal relationships, health behaviors, access to health information, use of health services, and health promotion barriers and support. Using the needs assessment data, vignettes portraying typical individuals from this community will be developed. Stakeholders will be invited to participate in ideas generation and prioritization workshops for in-depth discussion on what works well and not well for the community. Contextually and culturally appropriate and meaningful action ideas will be co-designed to respond to identified health literacy strengths, needs, and preferences of the community. This protocol will develop and test new and improved methods that are likely to be useful for community-based organizations and health services to systematically understand and improve communication, services and outcomes among disadvantaged groups, particularly migrants and refugees.

Consistency of Delivery Mode Increases Chinese Mothers' Maternal Satisfaction: The Effect of Perception of Support from Medical Staff and Mothers' Self-Efficacy

Maternal satisfaction is essential for women. Extant research has focused on how a practical delivery method effects maternal satisfaction. This article tried to explore the effect of the consistency of delivery mode between mothers' expectations and their experience of maternal satisfaction and proposed the mediating effect of the perception of support from medical staff and the moderated mediation effect of maternal self-efficacy. Based on two studies, this article found that the consistency of the delivery mode has a positive effect on maternal satisfaction, and women's perception of support from medical staff mediated the above relationship. The maternal perception of self-efficacy has a moderated mediation effect; specifically, for women with a high level of self-efficacy, the positive effect of the consistency of the delivery mode on maternal satisfaction through perception support from medical staff is stronger. This article highlights the importance of the consistency of the delivery mode between women's expectations and the experience of maternal satisfaction and the psychological mechanisms involved. The results extend the theoretical research on ethics in childbirth and provide implications for improving women's maternal satisfaction from medical staff and themselves.

Health Literacy Development among People with Chronic Diseases: Advancing the State of the Art and Learning from International Practices

Chronic diseases account for a considerable part of the strain on health care systems [...].