Using the HLS19 instruments

Are you interested in using the HLS19 instruments?

An agreement for the use of the HLS19 instruments will be granted, if the following conditions are fulfilled:

  1. The use of the tool is non-commercial and in public interest.
  2. Any licensing by third parties is prohibited.
  3. The HLS19 Project must be acknowledged in any publication resulting from the use of the HLS19 instrument as ‘The HLS19 instrument used in this research was developed within “The European Health Literacy Population Survey 2019-2021 (HLS19)” of M-POHL’.
  4. The instruments have to be cited – citation suggestions are provided with the instruments.
  5. A PDF copy of publications resulting from the use of the HLS19 instrument must be provided to the ICC after publication.
  6. Any further translations of the instruments have to be provided to the ICC. The ICC and the HLS19 Consortium can use these translated versions for its further research. Any use of these versions is subject to the same rights and rules apply as to the original HLS19 instruments according to point 1 to 5. Furthermore, the new instruments can only be shared with others by a joint agreement between the ICC and the applicant. 

The HLS19 instruments are owned by the HLS19 Consortium. Any use of the HLS19 instruments requires a contractual agreement between the applicant and the HLS19 Consortium. For permission to use the English version of the instruments, the ICC will evaluate the application and decide whether to grant permission. For granting permission for translated versions the respective National Study Centre and the ICC will jointly evaluate the application and decide on giving permission. The use of the instruments is free of charge. A detailed overview of the available translations of the different HLS19 instruments can be found here: 

An application including a contractual agreement with the conditions for using the HLS19 instruments must be submitted. A template for the application and agreement can be found HERE.

Factsheets on the HLS19 instruments including information on psychometric properties can be found here.

Results & publications

Design & methods

Study Design

The HLS19 applied a multi-center cross-sectional study design. The study population was defined as all permanent residents aged 18 and above living in private households in the 17 participating countries. A total of 42,445 interviews were included in the study. National sample sizes were expected to be at least 1,000 but varied from 865 to 5,660 respondents. The participating countries used a multi-stage random sampling procedure or quota sampling, and most countries stratified samples by gender, age group, population density, and geographical areas/regions. Data were collected through face-to-face, telephone, or web-based interviews, or a combination of these. The timeframe for data collection was, due to the COVID-19 pandemic, from November 2019 to June 2021. 

HLS19 instruments

To measure general health literacy, an adapted 47-item instrument, the HLS19-Q47, and two adapted short forms, the HLS19-Q12 and the HLS19-Q16, were developed based on the HLS-EU-Q47 instrument to collect data. New instruments were developed to measure: 

  • Digital health literacy (HLS19-DIGI), 
  • Communicative health literacy with physicians in healthcare HLS19-COM-P-Q11 and HLS19-COM-P-Q6, a short form), 
  • Navigational health literacy (HLS19-NAV), 
  • Vaccination health literacy (HLS19-VAC)

Factsheets on the HLS19 instruments including information on psychometric properties can be found here. 

In addition, 31 core and 18 optional correlates were included in the HLS19 questionnaires. Participating countries had to implement at least the HLS19-Q12 and the 31 core correlates, all other parts were optional.

The HLS19 instruments were developed in English and translated by 16 of the 17 countries into their national language(s) (Ireland used the original English version), resulting in a wide range of languages in which the instruments are now available:  Arabic, Bulgarian, Czech, Danish, Dutch, French, German, Hebrew, Hungarian, Italian, Norwegian, Portuguese, Russian, Slovenian, and Slovak. In addition, some countries have translated the instruments also into migrant languages. As only the HLS19-Q12 was mandatory, not all instruments are available in all these languages.

A detailed overview of the available translations of the different HLS19 instruments can be found here: 

Results & publications

Tools

  • International Self-Assessment Tool for Organizational Health Literacy of Hospitals - short version (OHL-Hos-SF)

    The OHL-Hos-SF was developed by the M-POHL Working Group on Developing the OHL-Hos-SF, consisting of experts from 10 countries and involving hospital staff as “users of the tool”. The OHL-Hos-SF  has 8 standards (reflecting the OHL-Hos standards, but with revised wording, 19 sub-standards and 60 indicators (when including sub-indicators 72 items are used). The indicators for each sub-standard operationalize concrete observable or measurable elements.

    A factsheet on the OHL-Hos-SF can be found here. 
     

 

 

 

  • International Self-Assessment Tool for Organizational Health Literacy in Primary Health Care Services (OHL-PHC) 

    The OHL-PHC was developed by the M-POHL Working Group on Organizational Health Literacy in Primary Health Care Service consisting of experts from 13 countries. The tool builds on the OHL-Hos and the OHL Self-AsseT (De Gani et al. 2020).  It has 7 standards, 19 sub-standards and 51 indicators (when including sub-indicators 70 items are used). The indicators for each sub-standard operationalize concrete observable or measurable elements. The tool is applicable at any type of organization that offers primary care, such as primary care centers, offices of generalist health professionals, ambulatory health care centers, family planning centers and pharmacies. 

    A factsheet on the OHL-PHC can be found here.
     

Both tools are available as word and excel documents. Word versions provide detailed introductions, excel versions enable the automatic creation of result overviews in percentage and as graphs. Supporting tools for summing up results from individual assessment and enable the visualization of results by creating automatic graphs were created. Currently the tools are only available to M-POHL OHL partners. 
 

Reporting

Participating countries are encouraged to publish their national results of the OHL project. In the final phase of the project, an International Report will be produced.

 

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 Norway

Design & methods

The following activities are underway:

Assessment of organizational health literacy in hospitals

  • The International Self-Assessment Tool for Organizational Health Literacy (Responsiveness) of Hospitals (OHL-Hos), which was developed by the International Working Group on Health Promoting Hospitals and Health Literate Healthcare Organizations (HPH & HLO) will be used in the M-POHL OHL project. In a first step the tool will be translated, cultural adapted, and piloted in the participating M-POHL countries. Building on the piloting results the tool might be slightly modified and is then ready for a larger roll out.
  • In addition, a shortened assessment tool for hospitals will be developed based on the OHL-Hos tool as first piloting results showed that for some organizations a less extensive tool would be more acceptable and feasible.

Assessment of organizational health literacy in primary healthcare organizations and pharmacies

  • A M-POHL OHL working group has developed the International Self-Assessment Tool for Organizational Health Literacy in Primary Health Care Services (OHL-PHC) from 2022-2023. The OHL-PHC builds on the OHL-Hos and the OHL Self-AsseT (De Gani et al. 2020). 
  • Currently in 2024, first experiences on translating, cultural adapting and piloting of the tool are gained and shared with the OHL consortium.

Development, translation, cultural adaption, and piloting of the OHL assessment tools

A study design with five phases was developed by the International Coordination Center (ICC) of M-POHL: 

  • Phase 1: Initiation of the international project 
  • Phase 2: Development organizational health literacy assessment tools 
  • Phase 3: Translation and cultural adaption of the organizational health literacy assessment tools
  • Phase 4: Piloting of the organizational health literacy assessment tools in one or more healthcare organizations in each country
  • Phase 5: International collecting and integrating of national experiences and results in an international report. 

In addition, several documents and supporting tools were provided to facilitate the process of translation, cultural adaption, and piloting of the tools and the documentation of experiences and results gained in this process.

International exchange on experiences with organizational health literacy assessments

Participating countries can attend M-POHL OHL project consortium meetings for an international exchange on their national experiences on their work on assessing organizational health literacy. Currently first experiences on translation, cultural adaption, and piloting are shared. In future, experiences on facilitating the uptake of organizational health literacy assessment tools and on implementing organizational health literacy by roll out procedures in the countries will be shared.
 

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