Development and evaluation of an assessment tool for organisational health literacy

BackgroundIn research on organisational health literacy (OHL), there is a lack of standardised assessment tools for measuring and comparing the OHL of different organisations. This article therefore examines (1) which criteria for assessing OHL can be derived from research and practice, (2) how these are implemented in organisations and (3) the psychometric properties of a questionnaire developed from them. MethodologyOHL criteria were identified by means of literature research and workshops. The criteria were agreed upon in a Delphi study and an assessment tool was developed. An online questionnaire was developed and psychometrically tested. Measures such as Cronbach's alpha, item selectivity and difficulty, and floor/ceiling effects were used for the analysis. ResultsOver 500 criteria were identified and an assessment tool of 77 criteria (5 main categories and 17 sub-categories) was developed. The subject of "Barrier-free access and navigation" was best implemented in healthcare organisations. The psychometric properties showed a good to excellent internal consistency of the questionnaire structure. Only one main category showed significant floor effects; there were no ceiling effects. At the item level, ceiling effects were found for 13 items, and 39 items showed a satisfactory discriminatory power. DiscussionOHL is a multidimensional construct that is well represented by the assessment tool. Further validation with larger samples is necessary for the use of the tool as a questionnaire for measuring OHL and for comparison between institutions. A reduction in the number of criteria can improve the consistency of the content of the main and sub-categories.