Interventions to Enhance Organisational Health Literacy Responsiveness in Institutional and Community‐Based Settings for Children: A Systematic Scoping Review
Dilshan Wijeratne, Roberta Amoah, Rebecca Kelly, Shandell Elmer, Rosie NashABSTRACT
Issue Addressed
Organisational health literacy responsiveness (OHLR) reflects the capacity of healthcare, educational, and community organisations to respond and offer equitable access to health information and services. Evidence on interventions addressing children's health literacy needs across these settings remains fragmented. This review aimed to identify and characterise OHLR‐related interventions and map their reported outcomes.
Methods
A scoping review was conducted following Joanna Briggs Institute methodology. Six electronic databases and grey literature sources were searched for literature published from 2005 to October 2025. Of 1494 records, 33 studies met the inclusion criteria. Data were analysed using qualitative content analysis and reported intervention outcomes were mapped against the seven‐dimension Organisational Health Literacy Responsiveness (Org‐HLR) framework.
Results
The 33 studies were conducted in 14 countries and across hospital, school, and community‐based settings. Few interventions addressed all seven Org‐HLR dimensions. Communication practices were addressed in all studies, followed by workforce development ( n = 23) and access to services ( n = 21). Fewer studies addressed system processes ( n = 16), community engagement ( n = 16), and leadership and culture ( n = 15). Several interventions used participatory or co‐design approaches. Reported outcomes included improved communication, workforce capacity, service accessibility, and user engagement. Long‐term and system‐level outcomes were rarely assessed.
Conclusions
To reduce inequity in service provision, services need to consider their OHLR. Interventions identified in this review show potential to strengthen organisational capacity to respond to carer and children's health literacy needs, but approaches remain heterogeneous, fragmented, and evidence on sustained organisational and system‐level outcomes was limited. More research is warranted.
So What?
OHLR could guide equitable health promotion across schools, child and family health services, and services supporting culturally and linguistically diverse communities. Cross‐sector policies, workforce development, leadership, and meaningful participation can support the integration of OHLR into routine practice.