Evaluation of a Health Literacy Program for Chronic Conditions

BACKGROUND:Although much is known about health literacy in concept and practice, more research is needed to understand the mechanisms that improve health literacy and result in healthy behavior change. This is particularly so for those at risk of or living with chronic conditions who reside in communities experiencing socioeconomic disadvantage.OBJECTIVE:The program aimed to improve the prevention and management of chronic conditions by responding to health literacy needs.METHODS:A health literacy program, underpinned by Ophelia principles, was developed in consultation with three Neighbourhood Houses located in areas of socioeconomic disadvantage. Four 7-week group programs were delivered by a multidisciplinary team of academic health professionals. The evaluation aimed to explain how the design, content, and approach to delivery resulted in healthy behavior change and increased health literacy for the participants. Four focus groups were conducted to elicit feedback about the participants' experience of the program and recommendations for future programs. Data were thematically analyzed. The focus groups were attended by 22 (43%) of the total 51 program participants. Most of the participants were women with one or more chronic condition and residing in an area of socioeconomic disadvantage.KEY RESULTS:Four major themes were identified including the components of self-determination theory (SDT) (autonomy and competence and relatedness) and a separate, but related theme of empowerment. Recommendations for improving future programs were categorized separately.CONCLUSIONS:The SDT framework is a useful and novel approach to explaining the evaluation outcomes, the application of the Ophelia principles' underpinning design of the program, and the contribution of a multidisciplinary team of academic health professionals. Future programs will benefit from the SDT as a planning and evaluation framework, as well as understanding the long-term effects of the program within the broader community