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. 2021 Jul 21;21(1):716.
doi: 10.1186/s12913-021-06614-x.

"The system has to be health literate, too" - perspectives among healthcare professionals on health literacy in transcultural treatment settings

Annika Baumeister  1 , Digo Chakraverty  2 , Angela Aldin  3 , Ümran Sema Seven  2 , Nicole Skoetz  3 , Elke Kalbe  2 , Christiane Woopen  4
Affiliations

"The system has to be health literate, too" - perspectives among healthcare professionals on health literacy in transcultural treatment settings

Annika Baumeister et al. BMC Health Serv Res. .

Abstract

Background: Effective communication is a central aspect of organizational health literacy. Healthcare professionals are expected to ensure an effective and satisfactory flow of information and to support their patients in accessing, understanding, appraising, and applying health information. This qualitative study aimed to examine the health literacy-related challenges, needs, and applied solutions of healthcare professionals when engaging with persons with a migrant background. Based on the integrated model of health literacy (Sørensen et al., BMC Public Health 12:80, 2012), we focused on environmental, personal, and situational factors that shape health literacy in transcultural treatment settings.

Methods: We conducted five focus group discussions with healthcare professionals (N = 31) who are in regular contact with persons with a migrant background. Discussions were transcribed verbatim and analyzed using qualitative content analysis by applying a deductive-inductive categorization procedure. Deductive categories were derived from the integrated model of health literacy.

Results: Challenges included a mismatch in the provision and use of health services. Participants regarded easily accessible services and outreach counselling as helpful solutions. Further challenges were the migrant patients' distrust in healthcare professionals and the German healthcare system, the participants' uncertainty in dealing with patients' expectations and needs, and the patients' non-compliance with appointments. Environmental factors included systemic lack of time and economic pressure. Both were reported as impeding the flow of information in all treatment settings. Participants with a migrant background themselves (n = 16) regarded this personal factor as an opportunity that increased patients' trust in them. They also reported challenges such as high levels of responsibility felt when ad hoc interpreting for colleagues.

Conclusions: Known issues observed in the delivery of healthcare for the majority population (i.e., systemic lack of time, economic pressure) appear to be intensified in the context of migration. An increasingly diverse patient clientele indicates a growing need for culture-sensitive, health-literate healthcare organizations. A corresponding diversity of the health workforce is desirable and should be strengthened by national finance and educational programs. Healthcare professionals who interpret for colleagues should be given the necessary time. Further studies are needed to develop appropriate interventions for improving health literacy at individual and organizational levels. Funding for interpreting services should be expanded.

Keywords: Ethnic concordance; Health communication; Migration; Organizational health literacy; Qualitative research.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Simplified version of the integrated model of health literacy. Adapted from the Sorensen et al. (2012) [3].
Fig. 2
Fig. 2
Pathways of deductive main categories (bold) and exemplary inductive subcategories of health literacy-related challenges and applied solutions in the transcultural treatment settings. HCPs: healthcare professionals
See this image and copyright information in PMC

References

    1. Weishaar H, Hurrelmann K, Okan O, Horn A, Schaeffer D. Framing health literacy: a comparative analysis of national action plans. Health Policy. 2019;123(1):11–20. doi: 10.1016/j.healthpol.2018.11.012. - DOI - PubMed
    1. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association Health literacy: report of the Council on Scientific Affairs. JAMA. 1999;281:552–557. doi: 10.1001/jama.281.6.552. - DOI - PubMed
    1. Sørensen K, van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12(1):80. doi: 10.1186/1471-2458-12-80. - DOI - PMC - PubMed
    1. Dodson S, Beauchamp A, Batterham RW, Osborne RH. Ophelia Toolkit: A step-by-step guide for identifying and responding to health literacy needs within local communities. Part A: Introduction to health literacy. Melbourne: Deakin University; 2014. Information sheet 1: What is health literacy?
    1. Sørensen K, Pelikan JM, Röthlin F, Ganahl K, Slonska Z, Doyle G, Fullam J, Kondilis B, Agrafiotis D, Uiters E, Falcon M, Mensing M, Tchamov K, van den Broucke S, Brand H, HLS-EU Consortium Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU) Eur J Pub Health. 2015;25(6):1053–1058. doi: 10.1093/eurpub/ckv043. - DOI - PMC - PubMed