Communication ETDs

Publication Date

Summer 7-1-2017


Nearly nine in ten U.S. adults struggle to use increasingly complex healthcare organizations and to understand the information these organizations provide. However, healthcare organizations are not yet widely addressing the need to make their services and health information easier to navigate, understand, and use.

The purpose of this study was to expand knowledge about the facilitators and barriers to adoption and implementation of health literacy initiatives in healthcare organizations. Sixteen qualitative interviews with individuals who lead health literacy initiatives in 16 organizations across the U.S. were conducted.

The study identified multiple facilitators and barriers to health literacy adoption and implementation efforts. Many of the elements had already been identified in the literature but four findings of this study were new. Executive level leadership support emerged as the most crucial element for success. Other important facilitators include (a) senior leadership being aware of the importance of addressing health literacy at the organizational level; (b) the person in charge of the health literacy initiative having authorization to meet with senior leaders, directors, and managers across the organization; (c) the health literacy office being located in an area with organization-wide authority; and (d) the use of a structured, strategic approach to plan and carry out change.

Each of these elements is potentially influential in adoption and implementation of other change initiatives in healthcare as well as in health literacy initiatives. Further research to explore these elements could contribute to the literature, and to practical applications, in health literacy and other healthcare initiatives.




health literacy, organizational health literacy, health literate organization, implementation, organizational change, facilitators and barriers

Document Type


Degree Name


Level of Degree


Department Name

Department of Communication and Journalism

First Committee Member (Chair)

Dr. Judith White

Second Committee Member

Dr. Tamar Ginossar

Third Committee Member

Dr. Laura Burton

Fourth Committee Member

Dr. Lorraine Wallace