Leader: Guglielmo Bonaccorsi (UNIFI); Other collaborator(s):
Strategies by which healthcare organizations make it easier for people, in spite of their level of HL, to navigate, understand, and use information and services to take care of their health, providing clear services and information for all those seeking services to find and understand, to assist them in the decisions they make, and to eliminate existing barriers in these issues. These two dimension of HL can be key in taking care of older people, from family to institutionalized settings.
Brief description of the activities and of the intermediate results
- Drafting and submission to the Local Ethics Committee of the research project “Identification and proactive management of the frailty syndrome at the Casa della Salute "Le Piagge", Firenze”, a monocentric prospective longitudinal cohort, non-profit, on people of 75 year-old.
- Beginning of the training activities with the healthcare professionals of the House of Health (Casa della salute) “Le Piagge” and the dissemination activities with people living in this quarter.
- Presentation and sharing of the research project on Organizational Health Literacy to Careggi teaching Hospital. one of the focuses is how OHL can forefront the difficulties to access hospital healthcare services - particularly for older people.
- Participation to the Spoke 3 Internal Meeting held in Bologna.
- Finalization of the manuscript: How to communicate with older adults about climate change: a systematic review. S. Pinna, D. Longo, P. Zanobini, C. Lorini, G. Bonaccorsi, M. Baccini, F. Cecchi has been submitted to Frontiers in Public Health (published in April)
- Systematic review Measuring Digital Health Literacy among older adults: continuation of the review process.
- Finalization of the article “Enhancing Primary Healthcare through Interprofessional educationInsights from a Training Workshop”, which is going to be published in “Annali di Igiene” in April.
- Preparation for dissemination events with related abstract submissions:
- Spring Colloquium-Firenze (which will be held in May); 2) Congresso Nazionale Assistenti Sanitari - Roma (April); 3) Age-It Venezia)
- Data Analysis and drafting article on the role of HL in the dyad caregiver/older person (tentative title: Is health literacy associated with stress level among informal caregivers of older people with dementia? Results of a cross-sectional study conducted in Florence, Italy).
- Drafting of the paper on Digital HL among older adults.
- Drafting of the paper on HL-EU-Q6 validation for older people.
Main policy, industrial and scientific implications: Developing a specific tool to measure OHL in Hospital and in the Primary Care setting.
- Systematic Review on Digital Health Literacy Tools in older adults. After completing the full-text reading and conducting a quality assessment using the Crowe Critical Appraisal Tool (CCAT), the final draft of the paper is now close to submission.
- Identification and Proactive Management of Fragility Syndrome (House of Health Le Piagge). The project focused on identifying and proactively managing fragility syndrome in older adults at the House of Health Le Piagge was officially initiated during this period.
- Organizational Health Literacy (OHL) Study at Careggi Hospital. Meetings concerning the ongoing OHL study at Careggi Hospital have been pivotal in assessing how hospitals can address challenges faced by older adults when accessing healthcare services. Discussions also explored the potential expansion of the project to hospitals in other regions. This scaling up will be essential in understanding how different institutions manage OHL and how best practices can be shared across various healthcare settings.
- Empowering Sustainable Healthcare: The Role of Health LiteracyA key milestone during this period was the publication of the article in the journal Sustainability. This article highlights how improving health literacy, both at individual and organizational levels, can contribute to sustainable healthcare systems.
- Effectiveness of Older People’s Reading Groups An article focusing on the effectiveness of reading groups for older individuals has been submitted for review. This study investigates how participation in reading groups helps maintain mental health, fosters social relationships, prevents loneliness, and promotes physical health. Reading groups have been shown to offer a holistic approach to elderly care, providing both cognitive engagement and social interaction, crucial factors in preventing isolation and supporting overall well-being.
- (Submitted) An article focusing on the effectiveness of reading groups for older individuals has been submitted for review.
- Health Literacy Support Groups for Caregivers of People with Dementia. Another significant project involved measuring health literacy among caregivers of individuals with dementia, at the House of Health Le Piagge. Approval by the Comitato Etico Territoriale (CET) was obtained, marking an essential step forward for the project.
- Perceived and actual Health Literacy.The recruitment phase began for a project aimed at measuring both patients’ health literacy and how healthcare professionals perceive the health literacy levels of their patients. The study focuses on older patients at the IRCCS Don Carlo Gnocchi in Florence, will assess their health literacy skills using two different tools—one self-reported and the other objective—and examine how healthcare providers estimate those skills. This project is crucial in bridging gaps between patient knowledge and the healthcare system’s ability to effectively communicate and interact with older individuals with different cognitive and literacy abilities.
- Systematic Review on Digital Health Literacy Tools in older adults. Submitted for review. The article is now available at http://preprints.jmir.org/preprint/66199
- Identification and Proactive Management of Fragility Syndrome (House of Health Le Piagge).Preparations are underway for the recruitment of elderly participants for the research project. In this study, health literacy will be assessed and treated as a covariate of fragility, with planned activities aimed at improving health literacy for both older individuals and their caregivers. Finalization of the entire work process, meetings held with various work groups, sample selected, and team training completed
- Perceived and actual Health Literacy. Ongoing recruitment of patients and healthcare professionals is being conducted at IRCCS Don Carlo Gnocchi in Florence, to measure patients' health literacy and how healthcare professionals perceive it. Data collection is currently in progress.
- Health Literacy Support Groups for Caregivers of People with Dementia. Interviews with caregivers of individuals with dementia are being conducted alongside the organization of support group activities and health literacy assessments at the House of Health Le Piagge, Florence. Beginning of group sessions for the caregivers.
- Scoping review on Health literacy measurement tools among older adults.Final draft correction, on the way to submission.
- Validation of the HLS-EU-Q6 in PASSi Tuscan geriatric sample: Finalization of the paper.
- A new hospital-at-home model for integrated geriatric care: data from a preliminary Italian experience: Finalization of the manuscript already accepted for publication in JAMDA, together with the research group of prof Andrea Ungar (spoke 3, WP5).
Brief description of the activities and of the intermediate results:
- Identification and proactive management of the fragility syndrome: subjects’ enrolment has been completed, and the first level of screening is currently in progress.
- Support group activities and health literacy measurements for caregivers of people with dementia: Subjects’ enrolment was completed during the summer, and the group course concluded in mid-December. Data analysis is currently underway.
- Measuring patients’ health literacy and perceived health literacy by healthcare professionals: the questionnaire administration phase has concluded, and data analysis is underway.
- Organizational health literacy at Careggi university hospital (OHL-HOS): after completing the data collection phase, the analysis phase began.
- A new branch of the Health Literate Healthcare Organizations project is about to begin at Careggi University Hospital: CARE-OHL is a national multicentre study (in collaboration with the Universities of Brescia and Milan) aimed at assessing the level of organizational health literacy both in management and among patients, using a shortened version of the OHL-HOS, which first need to be translated and validated into Italian.
Main policy, industrial and scientific implications:
- Council of Europe, Human Rights and Biomedicine, in “Guide to health literacy - Contributing to trust building and Equitable access to healthcare”: Good practice “Health literacy for caregivers of older persons with different levels of dependency – Italy”; Good practice “Health care professionals working in nursing homes – Italy” (Guglielmo Bonaccorsi and Chiara Lorini, 2023)
- Ufficio Nazionale Antidiscriminazioni (UNAR), Council of Europe, “Improving health literacy at individual and organisational levels - Creating a solid alliance between stakeholders to promote human rights” (Report, Guglielmo Bonaccorsi and Chiara Lorini, December 2024)
Brief description of the activities and of the intermediate results:
Patients' health literacy and perceived health literacy by health care professionals: enrollment of new patients is ongoing at Careggi Hospital, and we are organizing further recruitment of patients and general practitioners in primary healthcare. The manuscript for the study protocol has been finalized.
The JACARDI project (which enrolls also women in the age class 65-75) has concluded its enrollment phase, and the analysis of results and cluster definitions has started.
Frailty care-taking project at Casa della salute “Le Piagge”: first-level screening is completed and started the second-level; the evaluation phase of the enrolled patients has been completed; follow-up is scheduled for July of this year. Currently, we are informing the general practitioners of the patients who tested positive in the screening to make further shared evaluations. The manuscript on the study protocol is ongoing.
Health Literacy support groups for caregivers of people with dementia: the second edition of the support groups has begun. Recruitment for the third edition has also started.
A detailed feedback report of the JACARDI project for healthcare professionals information and training has been prepared.
Scoping reviews on assessing tools for Health Literacy and digital Health Literacy: The responses from the journals’ editorial boards have arrived regarding both submitted manuscripts. We are currently working on revising the articles based on the peer reviewers' feedback.
Italian validation of the HLS-EU-Q6: The article has been completed and submitted.
Organizational HL: the article on the pilots led at Careggi, Empoli, and Pistoia hospitals has been completed and submitted. Currently, the feedback reports for the participating hospitals are being drafted.
The translation of the International Self-Assessment Tool for Organizational Health Literacy in Hospitals – Short Version (OHL-Hos-SF) has been completed, while the translation of the International Self-Assessment Tool for Organizational Health Literacy in Primary Health Care (OHL-PHC) is in progress, as well as its field implementation (context: Primary Health Care, Casa della salute).
OUTPUTS
- Dissemination Events:
- 2nd Congress of the National Board of Health Assistants “Dalle radici al futuro pensieri e azioni per la prevenzione del domani” - March 27, 2024, Rome
- 1st Spring colloquium SAPIS “Ricerca e innovazione in sanità. Il contributo delle professioni sanitarie tecniche, riabilitative e della prevenzione” - May 9 2024, Firenze
- General Meeting Age-It - May 20-22, 2024, Venice
- Global Health Literacy Summit IHLA “Health literacy for people and planet”- September 18-20, 2024, Rotterdam
- 57th National Congress S.It.I “La Sanità Pubblica per il futuro del paese: innovazione, alleanze e sinergie istituzionali per la prevenzione” - October 23-26, 2024, Palermo
- First Conference “Health Literacy and Human Rights, Trust Building and Equitable Access to Healthcare”, 12 December 2023, Rome
- Second conference “Health Literacy and human rights” 5 December 2024, Rome
- 20.3.2025: seminar presentation “Health Literacy for the Individual, the Community and the Healthcare Organisations”, Bocconi University, Milan
- 27.3.2025: Training event at AUSL Toscana Centro, Title: "Strategies for innovation in primary care: equity, Communication and places for health”, with interventions devoted to Health Literacy and Frailty screening
Scientific outputs:
- G. Rivasi et al. A new hospital-at-home model for integrated geriatric care: data from a preliminary Italian experience. DOI: 10.1016/j.jamda.2024.105295
- C. Milani et al. Enhancing Primary Health Care through Interprofessional education: Insights from a Training Workshop. DOI: 10.7416/ai.2024.2631
- S. Pinna, D. Longo, P. Zanobini, C. Lorini, G. Bonaccorsi, M. Baccini, F. Cecchi How to communicate with older adults about climate change: a systematic review.
- Shared Reading interventions to promote psychosocial wellbeing in older adults: A systematic review (Under review)
- Measuring Digital Health Literacy in older people. A scoping review (Under review)
- Measuring Health Literacy in older people: a scoping review (Under review)