Exploring health literacy development through co-design: understanding the expectations for health literacy mediators

Health promotion efforts that enhance health literacy among individuals, organizations, and communities are gaining attention globally. Additionally, co-designed and community-led health promotion interventions have gained recognition as an effective strategy for addressing health issues through more effective and sustainable health outcomes. This qualitative study conducted in Tasmania, Australia, aimed to co-design the emerging Health Literacy Mediator (HLM) and to assess the support, expectations, and need for such a role. Following an Ophelia approach, data for this research were collected via focus group discussions within an online workshop, enabling diverse perspectives to emerge and be analysed via thematic analysis. Discussions around how the role could impact the individuals and families presented in the short case scenarios (vignettes) produced four strong expectations: that they are solution-focused, that they have a duty to facilitate change, that the role is based in community, and that the role targets those in the community who need them most to ensure the greatest impact. Participants also shared other recommendations and supporting ideas for the role. The potential role of HLM holds substantial promise in addressing health inequities for all individuals, regardless of background or socioeconomic status, by optimizing time management, simplifying navigation, ensuring the right care, and building community trust. By creating connections and advocating for individuals, HLMs could effectively break down barriers to healthcare access. This proactive approach not only addresses immediate health concerns but could also lay the groundwork for sustained improvements in public health outcomes in the future.