Once you’ve decided the focus of your health literacy review, you’ll need to bring together a review team with a mix of skills and expertise.
This is an opportunity for the reviewers to be trained and work through the planning and ethics requirements of a review.
Reviewers will bring a range of skills and knowledge to the review such as expertise in health literacy, how the health system operates, and the processes and procedures used in your organisation and the service under review.
Reviewers also need to be culturally competent.
Reasons for training
Training sessions can help the review team to develop knowledge and consensus around health literacy.
The reviewers may also want to carry out exercises to enhance their awareness of health literacy issues. For example, team members might:
- navigate an unfamiliar health service
- spend time in a service reception area to observe interactions
- analyse the clarity and relevance of information sent to a consumer.
Before training, reviewers can read about health literacy. Here are two great places to start.
- 3 Steps to Better Health Literacy: A guide for health care professionals
- 10 Attributes of Health Literate Health Care Organizations
A session plan for training is available in Appendix 3 of the Guide.
The following video has examples of how organisations arranged training.
Cheryl Goodyer (Manager, Capability, Māori Health Development Group, CCDHB):
Initially, after we had identified who our key stakeholders were, and that included people that were both interested in being involved in the work but also those that were interested on the periphery, I believe it was important to engage all of them, to (a) give them an understanding of what a health literate organisation looks like, but (b) also assist with the project in moving forward.
So once we’d identified those that potentially could be involved, we set up a training afternoon and that was the opportunity to give them the information and get them to ask questions to increase their knowledge of what was going to happen.
Dr Siniva Sinclair (Public Health Physician, CMDHB):
When we trained the reviewers, we brought the potential reviewers together with the service manager for a half-day training session with Workbase and that was really useful. Even though the service manager wasn’t going to be a reviewer, it gave her a good insight into what the review was going to cover.
Andrea Taylor (Nurse Consultant/Manager, Health of Older People and Clinical Support, NDHB):
The key is getting the knowledge about health literacy. Absolutely you need a grounding and an understanding, and I guess it wasn’t until I got my head around the 6 dimensions that that really started to pull together.
The buddying system with somebody who’s got the knowledge of health literacy was key. To observe somebody prior to me having a go, taking notes, reflection, and personal learning, it’s all about self-learning before you jump into observing other people.
Susan Reid (Consulting Manager, Workbase):
Training reviewers is really to get them to understand what health literacy is and what they’re looking for when they use the different methods to collect data, particularly what they’re looking for when they do observations of health professionals working with consumers and patients and families.
And we start off with what people know because people have a real range of understandings of what health literacy is and then make sure they understand that health literacy has evolved over the years. I mean it started in the 1970s and it’s evolved now so it’s shifted from a real patient focus right the way through to understanding that systems and processes impact on it and health professionals have a real role to play, so we make sure there’s that understanding.
And then we’ll talk about how you might see health literacy in the environment and in observations so in the guide there’s some practice exercises that reviewers can do.
One of the things reviewers found tricky in the trial of the guide was separating out what was a service issue from what was a health literacy issue. So often because they knew the service, they would think ‘oh, that’s not happening very well’ and think ‘oh, we need to do something about that’ but it wasn’t a health literacy issue.
[Logos: Ministry of Health and Workbase]
In preparation for a review, reviewers could also look at:
- Raising organisational awareness
- Tips for choosing a focus area and getting started
- Tips for clinical observations
- Experiences of environmental observations
- Tips for interviewers
- Tips for analysing documents
- Tips for using existing data
- Exploring the patient journey
An online course in cultural competency is available through LearnOnline.