The M-POHL OHL Project 

One of the ways to improve the health literacy responsiveness of healthcare organizations is by integrating the organizational health literacy approach into organizational quality management. Therefore, already in 2022, M-POHL began a project with the aim of facilitating the assessment of organizational health literacy in healthcare organizations. These efforts were prolonged. The timeframe of this project is from 2023-2027. 

Why does M-POHL focus on organizational health literacy in healthcare organizations?

• Improvements in health literacy are essential for successful healthcare, disease prevention, and health promotion.
• It is possible and meaningful to address low health literacy at the organizational level, where navigation support can be provided, communication can be improved through staff training, and people can be supported in making decisions and taking actions related to their health.
• The organizational approach allows for a systematic and sustainable implementation of health literacy measures in healthcare organizations as part of its quality management system.

Factsheet on OHL.

Aims

The main aim of the M-POHL OHL project is:

• to initiate and facilitate the assessment of organizational health literacy in healthcare organizations by developing, providing, and disseminating organizational health literacy assessment tools.

Thereby we aim to support healthcare organizations

• to engage with the issue of organizational health literacy,
• to obtain information about the strengths and weaknesses of organizational health literacy in their organization, and
• to improve their organizational health literacy.

Participants

Currently (in 2024) 17 M-POHL member countries have joined the OHL consortium: Austria, Belgium, Bulgaria, Czech Republic, Denmark, Germany, Israel, Ireland, Italy, Kazakhstan, Netherlands, Norway, Portugal, Serbia, Slovenia, Sweden and Ukraine. 

Coordination

The OHL project is coordinated by an International Coordination Centre (ICC) located at the Austrian National Public Health Institute (Gesundheit Österreich GmbH).

Core team of the International Coordination Centre (ICC) and their roles/responsibilities: 

• Robert Griebler - Scientific Coordinator
• Christa Straßmayr - Project Coordination and Research
• Thomas Link - Statistics and Research
• Denise Schütze - Statistics and Research

Further Information

• Factsheet on OHL

About the HLS₂₄

M-POHL aims to provide empirical data for monitoring health literacy in the WHO European Region, and this is best done by institutionalizing regular, high quality internationally comparative population health literacy surveys. Based on results from HLS₁₉, it was recommended that the health literacy of the adult resident population should be measured periodically in as many countries as possible. Therefore, a next health literacy population survey, the Health Literacy Survey 2024-2026 (HLS₂₄), was initiated with an overall project timeline from 2023 to 2027.

HLS₂₄ will allow countries that have already participated in HLS₁₉ to comparatively monitor their population health literacy, and new countries to initiate measuring adult population health literacy in their county. 

All participating countries will have the opportunity to contribute to the improvement of the HLS₁₉ measures on the specific health literacies - navigational, communicative, digital, and vaccination health literacy - and to the development of new specific instruments on mental and distributive health literacy and relevant covariates, i.e., determinants or consequences or mediators or moderators of health literacy, for the next round of international measurement. 
Participating countries will be support in translating instruments from generic English versions into their national languages, in pretesting these instruments and. in data cleaning. The ICC handles data processing for all countries and analyzes the country data to produce the HLS₂₄ International Report with co-authors from the participating countries. The ICC also supports follow-up articles in peer-reviewed journals. Based on HLS₂₄ data recommendations for policy, practice and research will be provided. 

Participants

Currently (in 2024) 22 M-POHL member countries plan to conduct the HLS₂₄: Austria, Belgium, Bulgaria, Czech Republic, Denmark, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, 
Kazakhstan, Netherlands, Norway, Moldova, Portugal, Serbia, Slovakia, Slovenia, Switzerland, and Ukraine. 

Coordination

The HLS₂₄ is coordinated by an International Coordination Centre (ICC) located at the Austrian National Public Health Institute (Gesundheit Österreich GmbH).

Core team of the International Coordination Centre (ICC) and their roles/responsibilities: 

• Robert Griebler - Scientific Coordinator
• Christa Straßmayr - Project Coordination and Research
• Thomas Link - Statistics and Research
• Denise Schütze - Statistics and Research

Design & methods

The HLS₂₄ will apply a multi-center cross-sectional study design. The study population is defined as all permanent residents aged 18 and above living in private households in the participating countries. National sample sizes are expected to be at least 1,000 respondents. The participating countries will use a multi-stage random sampling procedure or quota sampling. Data will be collected primarily in face-to-face or web-based interviews, or a combination of these. The timeframe for data collection will be between July 2024 and June 2026. 

The study design includes measuring general health literacy as well as specific types of health literacies should be measured. Besides the four specific health literacies measured in HLS₁₉ (navigational, communicative, digital, and vaccination health literacy), optional packages on mental health literacy and distributed health literacy will be provided. Data will be jointly analysed, and results will be published in national and international reports. 

Further Information 

• Factsheet HLS₂₄.

About the HLS₁₉

The Health Literacy Survey 2019-2021 (HLS₁₉) was M-POHL’s first project. Its aim was to measure population health literacy in as many member countries of the WHO European Region as possible. To plan and carry out this project, a consortium of participating countries was set up to make decisions, and working groups were formed to develop the study design as well as new survey instruments to measure navigational health literacy, communicative health literacy, digital health literacy, vaccination health literacy and the costs and economics of health literacy in addition to general health literacy.

Participants

Partners from M-POHL member countries were eligible to participate in HLS₁₉. They had to participate with a policy and a research representative so that both perspectives could work together in preparing and implementing the survey and using the results to improve population health literacy. To fulfill the research role, a National Study Center (NSC) was contracted to conduct the HLS₁₉ nationally, provide a national report the results, and represent the HLS₁₉ member country at the HLS₁₉ Research Assembly. For the policy role in the HLS₁₉, the national Ministry of Health usually sent a member of its own staff or nominated a representative from another suitable institution to the HLS₁₉ Policy Assembly. 

17 countries in the WHO European Region participated in the HLS₁₉ in the period 2019-2021: Austria, Belgium, Bulgaria, Czech Republic, Denmark, France, Germany, Hungary, Ireland, Israel, Italy, Norway, Portugal, Russian Federation, Slovakia, Slovenia, and Switzerland. 

Coordination

The HLS₁₉ was coordinated by an International Coordination Centre (ICC) located at the Austrian National Public Health Institute (Gesundheit Österreich GmbH).

Core team of the International Coordination Centre (ICC) and their roles/responsibilities: 

• Jürgen M. Pelikan – Scientific Coordinator
• Christa Straßmayr - Project Coordination and Research
• Robert Griebler – Research
• Thomas Link – Statistics and Research
• Dominika Mikšová - Statistics and Research
• Peter Nowak – Finance and Contracting

M-POHL is open to all member states of WHO-Europe and enables associated membership for non-WHO European countries which are interested in joining at least one of the M-POHL projects. Observer status is also possible. In the Governance and Work Structure of M-POHL details on becoming a member, associated member and observer are outlined.

Why participate?

M-POHL contributes to the much-needed evidence on health literacy. M-POHL connects expertise from research and policy and fosters evidence-based policy and practice. It puts health literacy on the international and national agenda sustainably. Thus, participation in M-POHL provides a high-level international exchange on up-to-date health literacy developments, data, evidence, and lessons learned to improve research and national policies, as well as participating in framing the international health literacy agenda in close collaboration with WHO and other international bodies. Such agenda-setting for health literacy is needed more than ever since the orientation in the field of health is becoming increasingly challenging due to a number of dynamic trends, including health threats induced by the climate crisis, the chances and challenges of the digital transformation, pandemics like COVID-19, mental health challenges in the context of the current global multi-crisis, and the fast-growing medical and health knowledge and technologies.
Health literacy can help to mitigate the effects of these crises on health on different levels: health literacy guides and empowers individuals to increase their chances for health. Data on population health literacy and on health literate organizations, as well as evidence on effective interventions to improve health literacy, support decision makers in developing national policies on improving health literacy in populations and organizations, including healthcare systems. 
 

In 2023 the policy guide “Health literacy policies – how can they be developed and implemented?” was developed. It is a product of M-POHL, initiated and sponsored by the Swiss Federal Office of Public Health together with WHO/Europe and the Austrian National Public Health Institute.

The policy guide:

• shares insights from currently existing health literacy policies, strategies and action plans as well as expert experiences and opinions that aim to inspire the development of national health literacy policies and actions in Europe and beyond. 
• brings together insights from (1) existing literature on action plans and interventions, including an expert snowballing search within M-POHL and among other partners, (2) experience and good practices collected from the M-POHL members and other countries, and (3) feedback collected in webinars with policy- and decision-makers from M-POHL members and other countries;
• supports policy- and decision-makers as well as public administrators in reflecting, initiating, developing and implementing effective measures to improve health literacy of the population and health literacy friendliness of health organizations and interventions.

The recording of the webinar on Dec 6 with policy- and decision-makers can be found HERE.

The guide “Health literacy policies – how can they be developed and implemented?” can be downloaded HERE.

Videos on national experiences:

We would like to invite countries to contribute to the knowledge transfer by sending a video sharing their national experiences on health literacy policy work and in implementing health interventions.

If you would like to contribute, please follow these steps:

• Record your presentation, e.g. with zoom (max. 15 mins, please see an example from Austria above)
• Send the final video to Angelika Schlacher (angelika.schlacher@goeg.at)
• A title page to your video including the logo of M-POHL, EVPOP, the country’s flag along with the presenter’s name will be added to the video by the ICC.
• The video will be published on https://m-pohl.net/ 

Process of the EVPOP project

Health literacy has become a global priority for health promotion, disease prevention and for the quality and outcomes of healthcare. As health literacy is considered critical to achieving health and limited health literacy is still a widespread phenomenon, the topic is steadily gaining increasing interest among policy- and decision-maker.

To meet the growing demand of decision-makers, a policy guide was launched in 2023 to support policy- and decision-makers and administrators in implementing effective policies and actions to improve population health literacy on a national level. It is a product of M-POHL, initiated by the Swiss Federal Office of Public Health together with WHO/Europe and the Austrian National Public Health Institute (Gesundheit Österreich GmbH).

For the 2024-2027 period, M-POHL’s efforts on evidence-based policies and practices will continue. Countries participating in this project will have the opportunity to present their national experiences in implementing health literacy interventions, to influence priority setting concerning the focus of evidence collecting and mapping on policies and interventions, and to learn from the experiences of the other participating countries. 

Participants

• Currently (in 2024) the EVPOP consortium is established – information on participating countries will follow.  

Coordination

The EVPOP project is coordinated by an International Coordination Centre (ICC) located at the Austrian National Public Health Institute (Gesundheit Österreich GmbH).

Core team of the International Coordination Centre (ICC) and their roles/responsibilities: 

• Robert Griebler - Scientific Coordinator
• Christa Straßmayr - M-POHL Coordination and Research
• Angelika Schlacher - EVPOP Project Coordination and Research
• Thomas Link - Statistics and Research
• Denise Schütze - Statistics and Research
• Fabian Saxinger - Research

National HLS₁₉ reports​

• Health Literacy in Israel – National Report HLS₁₉

Journal publications

Baron-Epel, Orna; Link, Thomas; Griebler, Robert; Bøggild, Henrik; Berens, Eva-Maria; Bíró, Éva; Coy, Deirdre; De Gani, Saskia Maria; Schaeffer, Doris; Sørensen, Kristine; Le, Christopher; Lopatina, Maria; Rowlands, Gillian; Touzani, Rajae; Van den Broucke, Stephan; Vincze, Ferenc; Vrdelja, Mitja; Vrbovsek, Sanja; Levin-Zamir, Diane (2025): Pathways of how health literacy and social support are associated with health outcomes in 17 European countries: Results of mediation analyses. In: Public Health 241/:12-12-18. https://www.sciencedirect.com/science/article/abs/pii/S0033350625000538

Levin-Zamir, Diane; Van den Broucke, Stephan; Bíró, Éva; Bøggild, Henrik; Bruton, Lucy; De Gani, Saskia Maria; Søberg Finbråten, Hanne; Gibney, Sarah; Griebler, Robert; Griese, Lennert; Guttersrud, Øystein; Klocháňová, Zuzana; Kucera, Zdenek; Le, Christopher; Link, Thomas; Mancini, Julien; Miksova, Dominika; Schaeffer, Doris; Ribeiro da Silva, Carlota; Sørensen, Kristine; Straßmayr, Christa; Telo de Arriaga, Miguel; Vrdelja, Mitja; Pelikan, Jürgen (2025): HLS19-DIGI - a new instrument for measuring digital health literacy: development, validation and associations with determinants and health outcomes in 13 countries. In: Frontiers in public health 13.  https://doi.org/10.3389/fpubh.2025.1472706

Journal publications

Petrova-Geretto E., Yanakieva A., Vodenicharova A. (2023): Health literacy: a call for action for a just and egalitarian society. SCIENCE International Journal, Vol.2 No.1. DOI: https://doi.org/10.35120/sciencej020137d

The guide “Health literacy policies – how can they be developed and implemented?” was presented at a webinar on Dec 6 2023. Besides the presentation of the guide, five countries provided a “reality check” of how health literacy policies were developed in their countries. The long version of the guide will be published on the M-POHL website at the end of January. The recording of the webinar can be found HERE.

As health literacy is considered critical to the achievement of health, and limited health literacy is still a widespread phenomenon, the topic is steadily gaining more interest from policy- and decision-makers. To meet the growing demand of decision-makers, a policy guide “Health literacy policies – how can they be developed and implemented?” was initiated to support policy-/decision-makers and administrators in implementing effective policies and actions to improve health literacy of the population on a national level. It is a product of M-POHL, initiated and sponsored by the Swiss Federal Office of Public Health together with WHO/Europe and the Austrian National Public Health Institute.