Abstract
The research project on "Regional Health Literacy Demonstration Sites for the Prevention and
Control of non-communicable diseases: Health Literate Organization Scaling up" aims to study and evaluate
the process of effective strategies to scale up health literate organizations to health literacy promoting
demonstration sites. We employed the Consolidated Framework for Implementation Research (CFIR) to
identify enabling factors and obstacles for the expansion, along with the Institute of Healthcare Improvement
(IHI framework), which divides operations into five phases. The IHI framework emphasizes the preparation of
pilot areas before implementing the model for full-scale expansion.
The research team selected health literate organization champions with the highest scores of
each of the five regions of Thailand the national conference on "Health Literate Organization of the Year"
2023, organized by Health Center 7 Khon Kaen, Department of Health, in Khon Kaen province. The pilot
implementation in the five areas took 3 to 6 months.
The results revealed that the CFIR framework, reflecting five key success factors, and the IHI
framework were suitable guidelines for systematically expanding health literate organization models into new
areas. The two frameworks supported each other, helping the research team define key and secondary
components of the model to prepare the pilot areas, as well as identify appropriate enabling factors for each
area. All areas were able to implement the key components of the model fully, and the health literacy levels
among the participants increased or approached those of the models. Additionally, the health outcomes of
participants improved significantly.
Our study also found that the expansion of health literate organizations models to the health
literacy promoting demonstration sites required at least four enabling factors: a local steering team, the
Health Literacy Promoting Demonstration sites, trainings for staff and health leaders, and core learning
materials. These factors aligned with the CFIR and IHI frameworks' recommendations for establishing support
systems.
The findings of this study suggest that scaling up a good model should use a theory-based
and a systematic approach, such as the CFIR and IHI frameworks. The necessary supporting factors that must
be developed prior to the pilot phase include at least four key factors: a local steering team, the Health
Literacy Promoting Demonstration sites, trainings for staff and health leaders, and core learning materials.
