ArticleBMC health services research2026
Development and validation of the Primary Care Organizations Organizational Health Literacy Scales (PCO-OHL Scales): a dual perspective from clients and healthcare providers.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrimary care organizations (PCOs) are crucial in promoting organizational health literacy (OHL), which helps individuals access, understand, and use health information. However, research on OHL in primary care is limited and often reflects a single perspective. This study aimed to develop the Primary Care Organizations Organizational Health Literacy Scales (PCO-OHL Scales) from the dual perspectives of clients and healthcare providers.
methodsThe study consisted of two phases. In Phase I, a framework was adapted, and items were developed via literature review, interviews, and field observations. After expert review and two Delphi rounds, an 18-item Parent Version was created and then adapted into parallel client and healthcare provider versions. Phase II assessed content validity via expert ratings and tested reliability (Cronbach' s α and test-retest) with 348 clients and 326 healthcare providers from 11 PCOs.
resultsThe final scales included six dimensions: Leadership and Management, Workforce, Access and Navigation, Communication, Consumer Involvement, and External Cooperation. Content validity (S-CVI/Ave) was 0.944 (client) and 0.956 (healthcare provider). Cronbach' s α was 0.926 and 0.889, and ICCs were 0.772 and 0.895, respectively. Survey data showed client and healthcare provider scores of 59.97 ± 10.01 and 65.81 ± 6.77. Among 18 item pairs, 5 received high ratings from both groups, 7 received relatively lower ratings from both groups, and 6 showed differences in ratings between clients and healthcare providers.
conclusionsThe PCO-OHL Scales are reliable, valid tools that capture both client and provider views. By incorporating dual perspectives, the scales enable a more comprehensive assessment of organizational practices and user experiences in primary care.
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