Who empowers whom? The role of organizational health literacy in empowering patients
DOI:
https://doi.org/10.7433/s104.2017.01Keywords:
organizational health literacy, health literacy, health communication, patient-centered care, pharmaciesAbstract
Purpose of the paper: This paper aims to explore the organizational health literacy of pharmacies, which are believed to perform as critical patient navigators in the health care arena. Organizational health literacy is understood as the ability of health care organizations to establish clear and comfortable relationships with their patients, involving them in a co-creating partnership.
Methodology: A comparative research design was arranged. Two convenience samples of pharmacies operating in two regional sub-systems of the Italian National Health Service (INHS) were built. Sixty units of analysis were included in the study; their organizational health literacy was examined in absolute and comparative terms.
Results: The units of analysis were aware of their role in enabling patients, but they did not conceive organizational health literacy as being either a strategic or a managerial tool to enhance their ability to empower patients and engage them in value co-creation.
Research limitations: Since the research concerned two convenience, non-representative samples, it is not possible to claim the findings’ generalizability.
Practical implications: Organizational health literacy should be conceived as a core idea inspiring pharmacies’ activities. In particular, health literacy should be dealt with as a driver to raise the awareness of the pharmacy’s role in enhancing the effectiveness and the appropriateness of care.
Originality of the paper: The scientific literature has focused most of its attention on the process of patient enablement; in contrast, the role of health care organizations in empowering patients has been overlooked. This is one of the first attempts to examine the organizational health literacy of pharmacies, investigating their ability to perform as patients’ navigators.
References
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ALGHURAIR S.A. (2012), “What elements of the patient-pharmacist relationship are associated with patient satisfaction?”, Patient Preference and Adherence, vol. 6, n. 1, pp. 663-676.
ANDERSON R.M., FUNNELL M.M. (2005), “Patient empowerment: reflections on the challenge of fostering the adoption of a new paradigm”, Patient Education and Counseling, vol. 57, n. 2, pp. 153-157.
ANNARUMMA C., PALUMBO R. (2016), “Contextualizing Health Literacy to Health Care Organizations: Exploratory Insights”, Journal of Health Management, vol. 18, n. 4, pp. 611-624.
AUJOULAT I., D’HOORE W., DECCACHE A. (2007), “Patient empowerment in theory and practice: polysemy or cacophony?”, Patient Education and Counseling, vol. 66, n. 1, pp. 13-20.
BAKER D.W. (2006), “The Meaning and the Measure of Health Literacy”, Journal of General Internal Medicine, vol. 21, n. 8, pp. 878-883.
BODDEWYN J. (1970), “Comparative Management Studies: An Assessment”, Management International Review, vol. 10, n. 2-3, pp. 3-11.
BOVAIRD T., LÖFFLER E. (2009), Public Management and Governance, Routledge, London.
BRACH C., DREYER B., SCHYVE P., HERNANDEZ L., BAUR C., LEMERISE A.J., PARKER R. (2012), Attributes of a health literate organization, The National Academies Press, Washington, DC.
BRAVO P., EDWARDS A., BARR P.J., SCHOLL I., ELWYN G., MCALLISTER M. (2015), “Conceptualising patient empowerment: a mixed methods study”, BMC Health Services Research, vol. 15, n. 1, pp. 252-265.
CAMERINI A.L., SCHULZ P.J. (2015), “Health Literacy and Patient Empowerment: Separating Conjoined Twins in the Context of Chronic Low Back Pain”, PLOS-One, vol. 10, n. 2, e0118032.
CAVALLONE M. (2007), “Gestire la comunicazione di marketing nella società multiculturale: problemi aperti e implicazioni per il management”, Mercati e Competitività, vol. 1, n. 1, pp. 95-117.
COLLINS S., BARBER A., SAHM L.J. (2014), “Pharmacist’s Counselling Improves Patient Knowledge Regarding Warfarin, Irrespective of Health Literacy Level”, Pharmacy, vol. 2, n. 1, pp. 114-123.
COLTMAN T.D., MIDGLEY D.F., VENIAK S. (2008), “Formative versus reflective measurement models: Two applications of formative measurement”, Journal of Business Research, vol. 61, n. 12, pp. 1250-1262.
DIAMANTOPOULOS A., SIGUAW J.A. (2006), “Formative versus reflective indicators in organizational measure development: a comparison and empirical illustration”, British Journal of Management, vol. 17, n. 4, pp. 263-282.
FOX-WOLFGRAMM S.J. (1997), “Towards Developing a Methodology for Doing Qualitative Research: The Dynamic-Comparative Case Study Method”, Scandinavian Journal of Management, vol. 13, n. 4, pp. 439-455.
EDWARDS M., WOOD F., DAVIES M., EDWARDS A. (2015), “‘Distributed health literacy’: longitudinal qualitative analysis of the roles of health literacy mediators and social networks of people living with a long-term health condition”, Health Expectations, vol. 18, n. 5, pp. 1180-1193.
FUMAGALLI L.P., RADAELLI G., LETTIERI E., BERTELE’ P., MASELLA C. (2015), “Patient Empowerment and its neighbours: Clarifying the boundaries and their mutual relationships”, Health Policy, vol. 119, n. 3, pp. 384-394.
FUNNELL M.M., ANDERSON R.M., ARNOLD M.S., BARR P.A., DONNELLY M., JOHNSON P.D., TAYLOR-MOON D., WHITE N.H. (1991), “Empowerment: an idea whose time has come in diabetes education”, The Diabetes Educator, vol. 17, n. 1, pp. 37-41.
GEORGE A.L. (1979), “Case studies and theory development: The method of structured, focused comparison”, in Lauren P.G., Diplomacy: New approaches in history, theory, and policy, Free Press, New York, NY, pp. 43-68.
HERNANDEZ L.M. (2013), Health Literacy: Improving Health, Health Systems, and Health Policy Around the World: Workshop Summary, The National Academies Press, Washington, D.C.
JACOBSON K.L., GAZMARARIAN J.A., KRIPALANI S., MCMORRIS K.J., BLAKE S.C., BRACH C. (2007), Is Our Pharmacy Meeting Patients’ Needs? A Pharmacy Health Literacy Assessment Tool User’s Guide, Agency for Healthcare Research, Rockville, MD.
JENNINGS B.T., MCADAM MARX C. (2012), “Implementation of a pharmacist-managed diabetes program”, American Journal of Health-System Pharmacy, vol. 69, n. 22, pp. 1951-1953.
JOHNSON J.L., MOSER L., GARWOOD C.L. (2013), “Health literacy: A primer for pharmacists”, American Journal of Health-System Pharmacy, vol. 70, n. 11, pp. 949-955.
KELLY P.A., HAIDET P. (2007), “Physician overestimation of patient literacy: A potential source of health care disparities”, Patient Education and Counseling, vol. 66, n. 1, pp. 119-122.
O’NEAL K.S., CROSBY K.M., MILLER M.J., MURRAY K.A., CONDREN M.E. (2013), “Assessing health literacy practices in a community pharmacy environment: Experiences using the AHRQ Pharmacy Health Literacy Assessment Tool”, Administrative Pharmacy, vol. 9, n. 5, pp. 564-596.
PALUMBO R. (2016a), “Contextualizing co-production of health care: a systematic literature review”, International Journal of Public Sector Management, vol. 29, n. 1, pp. 72-90.
PALUMBO R. (2016b), “Designing health-literate health care organization: A literature review”, Health Services Management Research, vol. 29, n. 3, pp. 79-87.
PALUMBO R., ANNARUMMA C. (2015), “Exploring the Organizational Health Literacy of Municipal Pharmacies: The Quest for a Health Literate Organizational Environment”, Toulon-Verona Conference “Excellence in Services” , August, 31st – September, 1st 2015, Palermo, Italy, p. 401-416.
PALUMBO R., ANNARUMMA C., ADINOLFI P., MUSELLA M. (2016a), “The missing link to patient engagement in Italy The role of health literacy in enabling patients”, Journal of Health Organization and Management, vol. 30, n. 8, pp. 1183-1203.
PALUMBO R., ANNARUMMA C., ADINOLFI P., MUSELLA M., PISCOPO G. (2016b), “The Italian Health Literacy Project: Insights from the assessment of health literacy skills in Italy”, Health Policy, vol. 120, n. 9, pp. 1087-1094
PRIGGE J.K., DIETZ B., HOMBURG C., HOYER W.D., BURTOND J.L. (2015), “Patient empowerment: A cross-disease exploration of antecedents and consequences”, International Journal of Research in Marketing, vol. 32, n. 4, pp. 375-386.
ROSENTHAL M., MORALES E., LEVIN S., MURPHY L. F. (2014), “Building a team to fight diabetes: Pharmacy students’ perceptions about serving as patient navigators”, Currents in Pharmacy Teaching and Learning, vol. 6, n. 4, pp. 595-604.
SARTO F., VERONESI G., KIRKPATRICK I., CUCCURULLO C. (2016), “Exploring regionalism in public management reforms: the case of the Italian hospital sector”, Policy and Politics, vol. 44, n. 4, pp. 525-545.
SCHULZ P.J., NAKAMOTO K. (2013), “Health literacy and patient empowerment in health communication: the importance of separating conjoined twins”, Patient Education and Counseling, vol. 90, n. 1, pp. 4-11.
SWAIN S.D., WEATHERS D., NIEDRICH R.W. (2008), “Assessing Three Sources of Misresponse to Reversed Likert Items”, Journal of Marketing Research, vol. 45, n. 1, pp. 116-131.
TARN D.M., HERITAGE J., PATERNITI D.A., HAYS R.D., KRAVITZ R.L., WENGER N.S. (2006), “Physician communication when prescribing new medications”, Archives of Internal Medicine, vol. 166, n. 17, pp. 1855-1862.
VON WAGNER C., STEPTOE A., WOLF M.S., WARDLE J. (2009), “Health Literacy and Health Actions: A Review and a Framework from Health Psychology”, Health Education and Behaviour, vol. 36, n. 5, pp. 860-877.
WANG R.H., HSU H.C., LEE Y.J., SHIN S.J., LIN K.D., AN L.W. (2016), “Patient empowerment interacts with health literacy to associate with subsequent self-management behaviors in patients with type 2 diabetes: A prospective study in Taiwan”, Patient Education and Counseling, vol. 99, n. 10, pp. 1626-1631.
WEAVER N.L., WRAY R.J., ZELLIN S., GAUTAM K., JUPKA K. (2012), “Advancing organizational health literacy in health care organizations serving high-needs populations: a case study”, Journal of Health Communication, vol. 17, n. S3, pp. 55-66.
WEIJTERS B., CABOOTER E., SCHILLEWAERT N. (2010), “The effect of rating scale format on response styles: The number of response categories and response category labels”, International Journal of Research in Marketing, vol. 27, n. 3, pp. 236-247.
WILLIS C.D., SAUL J., BITZ J., POMPU K., BEST A., JACKSON B. (2014), “Improving organizational capacity to address health literacy in public health: a rapid realist review”, Public Health, vol. 128, n. 6, pp. 515-524.
ALGHURAIR S.A. (2012), “What elements of the patient-pharmacist relationship are associated with patient satisfaction?”, Patient Preference and Adherence, vol. 6, n. 1, pp. 663-676.
ANDERSON R.M., FUNNELL M.M. (2005), “Patient empowerment: reflections on the challenge of fostering the adoption of a new paradigm”, Patient Education and Counseling, vol. 57, n. 2, pp. 153-157.
ANNARUMMA C., PALUMBO R. (2016), “Contextualizing Health Literacy to Health Care Organizations: Exploratory Insights”, Journal of Health Management, vol. 18, n. 4, pp. 611-624.
AUJOULAT I., D’HOORE W., DECCACHE A. (2007), “Patient empowerment in theory and practice: polysemy or cacophony?”, Patient Education and Counseling, vol. 66, n. 1, pp. 13-20.
BAKER D.W. (2006), “The Meaning and the Measure of Health Literacy”, Journal of General Internal Medicine, vol. 21, n. 8, pp. 878-883.
BODDEWYN J. (1970), “Comparative Management Studies: An Assessment”, Management International Review, vol. 10, n. 2-3, pp. 3-11.
BOVAIRD T., LÖFFLER E. (2009), Public Management and Governance, Routledge, London.
BRACH C., DREYER B., SCHYVE P., HERNANDEZ L., BAUR C., LEMERISE A.J., PARKER R. (2012), Attributes of a health literate organization, The National Academies Press, Washington, DC.
BRAVO P., EDWARDS A., BARR P.J., SCHOLL I., ELWYN G., MCALLISTER M. (2015), “Conceptualising patient empowerment: a mixed methods study”, BMC Health Services Research, vol. 15, n. 1, pp. 252-265.
CAMERINI A.L., SCHULZ P.J. (2015), “Health Literacy and Patient Empowerment: Separating Conjoined Twins in the Context of Chronic Low Back Pain”, PLOS-One, vol. 10, n. 2, e0118032.
CAVALLONE M. (2007), “Gestire la comunicazione di marketing nella società multiculturale: problemi aperti e implicazioni per il management”, Mercati e Competitività, vol. 1, n. 1, pp. 95-117.
COLLINS S., BARBER A., SAHM L.J. (2014), “Pharmacist’s Counselling Improves Patient Knowledge Regarding Warfarin, Irrespective of Health Literacy Level”, Pharmacy, vol. 2, n. 1, pp. 114-123.
COLTMAN T.D., MIDGLEY D.F., VENIAK S. (2008), “Formative versus reflective measurement models: Two applications of formative measurement”, Journal of Business Research, vol. 61, n. 12, pp. 1250-1262.
DIAMANTOPOULOS A., SIGUAW J.A. (2006), “Formative versus reflective indicators in organizational measure development: a comparison and empirical illustration”, British Journal of Management, vol. 17, n. 4, pp. 263-282.
FOX-WOLFGRAMM S.J. (1997), “Towards Developing a Methodology for Doing Qualitative Research: The Dynamic-Comparative Case Study Method”, Scandinavian Journal of Management, vol. 13, n. 4, pp. 439-455.
EDWARDS M., WOOD F., DAVIES M., EDWARDS A. (2015), “‘Distributed health literacy’: longitudinal qualitative analysis of the roles of health literacy mediators and social networks of people living with a long-term health condition”, Health Expectations, vol. 18, n. 5, pp. 1180-1193.
FUMAGALLI L.P., RADAELLI G., LETTIERI E., BERTELE’ P., MASELLA C. (2015), “Patient Empowerment and its neighbours: Clarifying the boundaries and their mutual relationships”, Health Policy, vol. 119, n. 3, pp. 384-394.
FUNNELL M.M., ANDERSON R.M., ARNOLD M.S., BARR P.A., DONNELLY M., JOHNSON P.D., TAYLOR-MOON D., WHITE N.H. (1991), “Empowerment: an idea whose time has come in diabetes education”, The Diabetes Educator, vol. 17, n. 1, pp. 37-41.
GEORGE A.L. (1979), “Case studies and theory development: The method of structured, focused comparison”, in Lauren P.G., Diplomacy: New approaches in history, theory, and policy, Free Press, New York, NY, pp. 43-68.
HERNANDEZ L.M. (2013), Health Literacy: Improving Health, Health Systems, and Health Policy Around the World: Workshop Summary, The National Academies Press, Washington, D.C.
JACOBSON K.L., GAZMARARIAN J.A., KRIPALANI S., MCMORRIS K.J., BLAKE S.C., BRACH C. (2007), Is Our Pharmacy Meeting Patients’ Needs? A Pharmacy Health Literacy Assessment Tool User’s Guide, Agency for Healthcare Research, Rockville, MD.
JENNINGS B.T., MCADAM MARX C. (2012), “Implementation of a pharmacist-managed diabetes program”, American Journal of Health-System Pharmacy, vol. 69, n. 22, pp. 1951-1953.
JOHNSON J.L., MOSER L., GARWOOD C.L. (2013), “Health literacy: A primer for pharmacists”, American Journal of Health-System Pharmacy, vol. 70, n. 11, pp. 949-955.
KELLY P.A., HAIDET P. (2007), “Physician overestimation of patient literacy: A potential source of health care disparities”, Patient Education and Counseling, vol. 66, n. 1, pp. 119-122.
O’NEAL K.S., CROSBY K.M., MILLER M.J., MURRAY K.A., CONDREN M.E. (2013), “Assessing health literacy practices in a community pharmacy environment: Experiences using the AHRQ Pharmacy Health Literacy Assessment Tool”, Administrative Pharmacy, vol. 9, n. 5, pp. 564-596.
PALUMBO R. (2016a), “Contextualizing co-production of health care: a systematic literature review”, International Journal of Public Sector Management, vol. 29, n. 1, pp. 72-90.
PALUMBO R. (2016b), “Designing health-literate health care organization: A literature review”, Health Services Management Research, vol. 29, n. 3, pp. 79-87.
PALUMBO R., ANNARUMMA C. (2015), “Exploring the Organizational Health Literacy of Municipal Pharmacies: The Quest for a Health Literate Organizational Environment”, Toulon-Verona Conference “Excellence in Services” , August, 31st – September, 1st 2015, Palermo, Italy, p. 401-416.
PALUMBO R., ANNARUMMA C., ADINOLFI P., MUSELLA M. (2016a), “The missing link to patient engagement in Italy The role of health literacy in enabling patients”, Journal of Health Organization and Management, vol. 30, n. 8, pp. 1183-1203.
PALUMBO R., ANNARUMMA C., ADINOLFI P., MUSELLA M., PISCOPO G. (2016b), “The Italian Health Literacy Project: Insights from the assessment of health literacy skills in Italy”, Health Policy, vol. 120, n. 9, pp. 1087-1094
PRIGGE J.K., DIETZ B., HOMBURG C., HOYER W.D., BURTOND J.L. (2015), “Patient empowerment: A cross-disease exploration of antecedents and consequences”, International Journal of Research in Marketing, vol. 32, n. 4, pp. 375-386.
ROSENTHAL M., MORALES E., LEVIN S., MURPHY L. F. (2014), “Building a team to fight diabetes: Pharmacy students’ perceptions about serving as patient navigators”, Currents in Pharmacy Teaching and Learning, vol. 6, n. 4, pp. 595-604.
SARTO F., VERONESI G., KIRKPATRICK I., CUCCURULLO C. (2016), “Exploring regionalism in public management reforms: the case of the Italian hospital sector”, Policy and Politics, vol. 44, n. 4, pp. 525-545.
SCHULZ P.J., NAKAMOTO K. (2013), “Health literacy and patient empowerment in health communication: the importance of separating conjoined twins”, Patient Education and Counseling, vol. 90, n. 1, pp. 4-11.
SWAIN S.D., WEATHERS D., NIEDRICH R.W. (2008), “Assessing Three Sources of Misresponse to Reversed Likert Items”, Journal of Marketing Research, vol. 45, n. 1, pp. 116-131.
TARN D.M., HERITAGE J., PATERNITI D.A., HAYS R.D., KRAVITZ R.L., WENGER N.S. (2006), “Physician communication when prescribing new medications”, Archives of Internal Medicine, vol. 166, n. 17, pp. 1855-1862.
VON WAGNER C., STEPTOE A., WOLF M.S., WARDLE J. (2009), “Health Literacy and Health Actions: A Review and a Framework from Health Psychology”, Health Education and Behaviour, vol. 36, n. 5, pp. 860-877.
WANG R.H., HSU H.C., LEE Y.J., SHIN S.J., LIN K.D., AN L.W. (2016), “Patient empowerment interacts with health literacy to associate with subsequent self-management behaviors in patients with type 2 diabetes: A prospective study in Taiwan”, Patient Education and Counseling, vol. 99, n. 10, pp. 1626-1631.
WEAVER N.L., WRAY R.J., ZELLIN S., GAUTAM K., JUPKA K. (2012), “Advancing organizational health literacy in health care organizations serving high-needs populations: a case study”, Journal of Health Communication, vol. 17, n. S3, pp. 55-66.
WEIJTERS B., CABOOTER E., SCHILLEWAERT N. (2010), “The effect of rating scale format on response styles: The number of response categories and response category labels”, International Journal of Research in Marketing, vol. 27, n. 3, pp. 236-247.
WILLIS C.D., SAUL J., BITZ J., POMPU K., BEST A., JACKSON B. (2014), “Improving organizational capacity to address health literacy in public health: a rapid realist review”, Public Health, vol. 128, n. 6, pp. 515-524.
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2017-12-28
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