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Barriers and Facilitators to Implementing Health Literacy Practices in a Pediatric ENT Clinic: A Mixed-Methods Study
Carol J Howe1, Brennan Lewis, Shelby Edmondson
1Author Affiliations: Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth (Dr Howe); Department of Nursing, Children's Health, Dallas, Texas (Dr Lewis); and Medical School, The University of Texas Southwestern Medical Center, Dallas (Ms Edmondson).
Background:
Despite strong evidence of improved patient outcomes, clinicians have been slow to adopt health literacy practices.
Purpose:
To identify facilitators and barriers to implementing health literacy practices into clinical care.
Methods:
Stakeholders (N = 40) completed surveys of acceptability, appropriateness, feasibility, conviction, and confidence with teach-back practices. Using the Consolidated Framework for Implementation Research (CFIR), interviews (n = 12) were conducted and analyzed.
Results:
Most reported high acceptability, appropriateness, and feasibility, but low confidence in using teach-back. Facilitators included leadership engagement and relative advantage. Barriers were related to compatibility due to time and workflow constraints. The CFIR-ERIC (Expert Recommendations for Implementing Change) Implementation Strategy Matching Tool was applied to select implementation strategies.
Conclusions:
The CFIR framework along with the CFIR-ERIC Matching Strategy Tool helped the research team select strategies likely to yield successful implementation and sustained use of health literacy practices.
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