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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 and Osborne, Richard H. 2017, Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia), BMC public health, vol. 17, pp. 1-18, doi: 10.1186/s12889-017-4147-5.

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Title Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia)
Author(s) Beauchamp, AlisonORCID iD for Beauchamp, Alison orcid.org/0000-0001-6555-6200
Batterham, Roy W.ORCID iD for Batterham, Roy W. orcid.org/0000-0002-5273-1011
Dodson, Sarity
Astbury, Brad
Elsworth, Gerald R.ORCID iD for Elsworth, Gerald R. orcid.org/0000-0001-6306-7593
Mcphee, CrystalORCID iD for Mcphee, Crystal orcid.org/0000-0003-4192-4325
Jacobson, Jeanine
Buchbinder, Rachelle
Osborne, Richard H.ORCID iD for Osborne, Richard H. orcid.org/0000-0002-9081-2699
Journal name BMC public health
Volume number 17
Article ID 230
Start page 1
End page 18
Total pages 18
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2017
ISSN 1471-2458
Keyword(s) health literacy
health inequities
Ophelia
chronic disease
Health Literacy Questionnaire
HLQ
health service improvement
healthcare access
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
QUESTIONNAIRE HLQ
CARE
Summary 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.
Language eng
DOI 10.1186/s12889-017-4147-5
Field of Research 111799 Public Health and Health Services not elsewhere classified
1117 Public Health And Health Services
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30092375

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.