https://orcid.org/0000-0003-4122-1793
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Abstract
Background
Organizational health literacy responsiveness is the degree to which health care organizations support their patients’ health literacy needs e.g., by making physical or digital navigation and access easier or by making written information easier to understand. Organizational health literacy responsiveness has been sparsely explored in maternity care.
Aim
To explore health professionals’ perspectives on organizational health literacy responsiveness in Danish maternity care, underpinned by the seven areas described in the Organizational Health Literacy Responsiveness framework.
Methods
A qualitative study using a deductive approach and thematic content analysis. We conducted thirteen semi-structured interviews with health professionals working in maternity care.
Results
Several factors were identified that strengthens responsiveness. These include managers that adapt to local context and balance political influence, a holistic and person-centred culture for care, effective program planning and successful internal interdisciplinary collaboration, beneficial partnerships across sectors, and organizational structures and strategies to support responsiveness related to communication, accessibility, and navigation. However, stigmatization within the organizational culture presents a barrier to delivering holistic and person-centred care, health professionals lack support and strategies to respond to pregnant women with resistance towards services and non-attenders, information overload by health professionals increases misunderstandings, and different digital communication preferences between health professionals and pregnant women affected by organizational structures were potential barriers to responsiveness. Also, external interdisciplinary collaboration presented a challenge. The availability of time, resources, and educational support for staff was different between care programs to increase equitable solutions based on pregnant women’s different needs, but health professionals struggle to balance the differentiation.
Conclusion
This study highlights the complexity in the organization of maternity care, including several factors that strengthen or limit organizational responsiveness. There is a need to approach and accommodate the experienced barriers that prevent personalized and equitable care by increasing the organizational support for responsiveness.
PLAIN LANGUAGE SUMMARY
Organizational health literacy is the degree to which health care organizations support, adapt, and accommodate their patients’ health literacy needs. In this study, we explored health professionals’ perspectives on organizational health literacy responsiveness in Danish maternity care. We found that the organization of maternity care services greatly impacts a professional’s ability to respond to pregnant women’s health literacy needs. Several factors strengthened health literacy responsiveness in the organization of maternity care services, however barriers for responsiveness were also experienced by health professionals. Exploring the barriers identified in this study may help improve the organisation of maternity care services to respond in an equitable way to individual needs of pregnant women and increase health literacy responsiveness.
Authors’ contribution
M.M. drafted the manuscript and designed the tables and figures. M.M. and C.S.J. conducted interviews, independently analysed, and synthesised the results. R.D.M. informed and invited the participants to take part. B.R., R.D.M. and H.T.M. supervised the qualitative analyses. All authors were involved in revision of the manuscript and approved the final version.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The authors confirm that the data supporting the findings of this study are available on request to the corresponding author.
Notes
1 A digital record of the woman’s health data related to the pregnancy.
2 A plan written by the social worker for the woman’s pregnancy course if there are any specific social challenges.
3 A chart with the woman’s health data related to the pregnancy, which she brings to each appointment during the pregnancy course.
4 A Danish app used at included study sites for digital support, guidance and communication offered to pregnant women in maternity care.
5 The ability to interpret or understand behavior (one's own as well as that of others) that is psychologically motivated in terms of underlying intentions and mental states, such as thoughts, feelings, wishes, and intentions.