Evidence map›Paper›PMID 34897445›Full record

ArticleHealth promotion international2021

Building health literacy system capacity: a framework for health literate systems.

Kristine Sørensen, Diane Levin-Zamir, Tuyen V Duong, Orkan Okan, Virginia Visconde Brasil, Don Nutbeam

Abstract read
In one paragraph

Article in Health promotion international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  15. School-Based Cancer Education and Health Literacy: A Pre-Post Study on Cancer Prevention and System Navigation Among Brazilian Adolescents.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026
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  20. Co-Creating Organisational Health Literacy: Formative Evaluation and Feasibility Testing of OHL-Act.International journal of environmental research and public health · 2026
    Article

31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kristine SørensenGlobal Health Literacy Academy, Risskov, Denmark.ORCID 0000-0002-6179-7004
Diane Levin-ZamirDepartment of Health Education and Promotion, Clalit, Tel Aviv and School of Public Health, University of Haifa, Haifa, Israel.
Tuyen V DuongSchool of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.
Orkan OkanInterdisciplinary Centre for Health Literacy Research, Bielefeld University, Germany.ORCID 0000-0003-1714-4783
Virginia Visconde BrasilSchool of Nursing, Universidade Federal de Goiás, Goiânia, Brazil.
Don NutbeamSydney School of Public Health, University of Sydney, Sydney, Australia.ORCID 0000-0001-6497-2827

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The human and social implications of poor health literacy are substantial and wide-ranging. Health literacy represents the personal competencies and organizational structures, resources and commitment that enable people to access, understand, appraise and use information and services in ways that promote and maintain good health. A large-scale societal improvement of health literacy will require political buy-in and a systematic approach to the development of health literacy capacity at all levels. This article builds the case for enhancing health literacy system capacity and presents a framework with eight action areas to accommodate the structural transformation needed at micro, meso and macro levels, including a health literate workforce, health literate organization, health literacy data governance, people-centred services and environments based on user engagement, health literacy leadership, health literacy investments and financial resources, health literacy-informed technology and innovation, and partnerships and inter-sectoral collaboration. Investment in the health literacy system capacity ensures an imperative and systemic effort and transformation which can be multiplied and sustained over time and is resilient towards external trends and events, rather than relying on organizational and individual behavioural change alone. Nevertheless, challenges still remain, e.g. to specify the economic benefits more in detail, develop and integrate data governance systems and go beyond healthcare to engage in health literacy system capacity within a wider societal context.

Indexed as

Health LiteracyDelivery of Health CareGovernment ProgramsHumansLeadershipMedical Assistancecapacity buildinghealth literacyhealth literate organizationhealth literate systemsystem performance indicator

Identifiers

PMID34897445
PMCPMC8672927

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.