It’s estimated that nearly 50 per cent of people in Northern Ireland have low health literacy – with this being recognised as a significant public health concern across the world. Kathy Martin, Strategic Impact Manager at Community Development and Health Network, discusses how the organisation’s community-based projects are working towards improving health literacy, with the aim of reducing health inequalities.

Health literacy is about people having the knowledge and skills to obtain, understand, and use health information in their everyday lives.

There is a strong evidence base which links an individual’s health literacy levels to their social circumstances. Educational attainment strongly predicts good health literacy, and people with limited financial and social resources are more likely to have limited health literacy.

Community Development and Health Network (CDHN) believes that improving health literacy will lead to improved health outcomes, creating more effective use of health services, and therefore reducing inequalities in health.

Building Community-Pharmacy Partnership Health Literacy Pilots

Having funded over 850 partnerships to date, we have an abundance of evidence demonstrating the impact that Building Community-Pharmacy Partnership (BCPP) projects have on improving health in local communities.

CDHN was keen to explore how this approach could be used to improve health literacy. We funded two pilot projects which would use the BCPP model of delivery and have a specific focus on improving health literacy in their communities. We chose two significantly different groups for the pilot – the National Childbirth Trust which was working with new mothers, and Carrickfergus YMCA which was working with families.

CDHN delivered one-to-one training with the group leads and the participating pharmacists to ensure that they had a good understanding of health literacy and the intended impact of the projects. During the planning stages of the pilots, CDHN designed evaluation tools which included specific health literacy measures to capture the impact of the pilot projects.

Carrick YMCA and MediCare

‘At the start of the sessions, everyone got together to make breakfast, giving people the opportunity to strike up conversations and build relationships. It was clear through the project that different people have different levels of understanding of health literacy and it was great to see the knowledge increasing over the weeks.’

Mo Shearer, Carrick YMCA

National Childbirth Trust and Mccartan’s Pharmacy

‘Health literacy was a new term for most of us within the group. The BCPP programme helped us to explore many different topics and gauge the participants’ understanding of their own physical and mental health.       With a better understanding of health literacy, we hope to be able to improve general health and wellbeing in our communities.’

Stephanie Haughey, McCartan’s Pharmacy

Measuring and Evidencing Impact

Over the last year, the team invested much time reviewing and redesigning the entire BCPP programme, including the evaluation framework. CDHN conducted a wide search for evidence-based measurement tools and, after assessing their appropriateness, updated the existing tools. The new framework includes measurements for health literacy in all the funded projects.

The outcomes are mapped to key policy documents, such as Making Life Better, Making it Better through Pharmacy in the Community, Programme for Government and Delivering Together. The data is aggregated to produce programme-wide reports which evidence the contribution of the BCPP programme to these strategic policy objectives. We expect to have the data set for a full year’s reporting by autumn 2020.

Self-Care Pharmacy Project

Building on the success of the BCPP pilots, CDHN was funded by the Health & Social Care Board to deliver the Self-Care Pharmacy Project. This project aims to improve the knowledge and understanding of self-care for minor ailments through a health literacy approach. Reflecting CDHN’s belief that improving health literacy will lead to improved health outcomes and reduced health inequalities, the project will deliver health literacy training to community leaders and community groups. The development of this training is informed by insights gathered at regional community workshops where people have been asked to share their experiences and understanding of health literacy, self-care and minor ailments. The final stage of the project will be two Design Thinking Workshops with multidisciplinary teams (local community, pharmacy, GP and other health sector representatives), with the aim of exploring the challenges for people to self-care for minor ailments and subsequently identifying solutions.