Titel: Recommendations for the use of organizational health literacy for changing the
participation of ethnic minorities in preventive health interventions.
Background: There is a higher occurrence of preventable chronic diseases amongst ethnic
minorities than ethnic Danes. At the same time ethnic minorities use preventive health
interventions less, despite a higher use of other medical services. Health literacy is emphasized
as a determinant for the health and disease of ethnic minorities. A more recent focus within
health literacy research shows that, health literacy is created in an interaction between
individual and organizational health literacy. However, for many years there has been great
focus put on individual health literacy, while organizational health literacy has been relatively
overlooked. To that there is a lack of knowledge of organizational health literacy in relation to
prevention.
Aim: The aim is, from a critical realistic perspective, to examine mechanisms that influence
the participation of ethnic minorities in preventive health interventions, and how organizations
that provide preventive health interventions can use organizational health literacy in order to
improve the access to these interventions for ethnic minorities.
Methods: A qualitative literature review was carried out. A search for studies that contribute
qualitative knowledge on the participation of ethnic minorities in preventive health
interventions was conducted in PubMed, Embase, Cinahl, ProQuest, PsykNet and Scopus.
Extraction of data was carried out in Nvivo 12, after which data was synthesized into themes,
and each theme was analyzed based on the Org-HLR framework by Trezona et al. (2017),
which frames organizational health literacy in this thesis.
Results: 19 articles were included, which contributed to barriers and facilitators for the
participation of ethnic minorities in preventive health interventions. The identified barriers and
facilitators for the participation of ethnic minorities in preventive health interventions relate to
eight themes; navigation in the healthcare system, social network, work processes,
understandings of disease, the intervention form, communication, the organizational resources
and accessibility. All seven domains in the Org-HLR framework contribute with strategies that
can meet the identified barriers and facilitators, in particular, community engagement and
partnerships. However, there are also limitations when using the framework.
Conclusion: Barriers and facilitators for ethnic minorities' participation in preventive health
interventions are dependent on the time and context in which they take place. A systematic
approach to becoming a health literate responsive organization can contribute positively to a
change in participation of ethnic minorities in preventive healthcare. However, it requires an
active choice and an allocation of resources towards it. Political prioritization can support the
change. Future research should investigate ethnic minorities' use of preventive health
interventions. Moreover there should be a focus on unintended consequences when using the
Org-HLR framework.