Director Primary Health Care, Broken Hill University Department of Rural Health, The University of Sydney, Broken Hill, Australia.
Head of Department, Broken Hill University Department of Rural Health, The University of Sydney, Broken Hill, Australia.
Prim Health Care Res Dev. 2020 Dec 2;21:e57. doi: 10.1017/S1463423620000481.
Despite the substantial investment by Australian health authorities to improve the health of rural and remote communities, rural residents continue to experience health care access challenges and poorer health outcomes. Health literacy and community engagement are both considered critical in addressing these health inequities. However, the current focus on health literacy can place undue burdens of responsibility for healthcare on individuals from disadvantaged communities whilst not taking due account of broader community needs and healthcare expectations. This can also marginalize the influence of community solidarity and mobilization in effecting healthcare improvements.
The objective is to present a conceptual framework that describes community literacy, its alignment with health literacy, and its relationship to concepts of community engaged healthcare.
Community literacy aims to integrate community knowledge, skills and resources into the design, delivery and adaptation of healthcare policies, and services at regional and local levels, with the provision of primary, secondary, and tertiary healthcare that aligns to individual community contexts. A set of principles is proposed to support the development of community literacy. Three levels of community literacy education for health personnel have been described that align with those applied to health literacy for consumers. It is proposed that community literacy education can facilitate transformational community engagement. Skills acquired by health personnel from senior executives to frontline clinical staff, can also lead to enhanced opportunities to promote health literacy for individuals.
The integration of health and community literacy provides a holistic framework that has the potential to effectively respond to the diversity of rural and remote Australian communities and their healthcare needs and expectations. Further research is required to develop, validate, and evaluate the three levels of community literacy education and alignment to health policy, prior to promoting its uptake more widely.
尽管澳大利亚卫生当局投入了大量资金来改善农村和偏远社区的健康状况，但农村居民仍然面临着医疗保健获取方面的挑战和较差的健康结果。健康素养和社区参与都被认为是解决这些健康不平等问题的关键。然而，目前对健康素养的关注可能会给弱势群体社区的个人带来不必要的医疗保健责任负担，而没有充分考虑到更广泛的社区需求和医疗保健期望。这也可能使社区团结和动员在改善医疗保健方面的影响力边缘化。
本研究旨在提出一个概念框架，描述社区素养，及其与健康素养的一致性，以及与社区参与式医疗保健概念的关系。
社区素养旨在将社区知识、技能和资源整合到医疗保健政策和服务的设计、提供和调整中，以在区域和地方层面提供初级、二级和三级医疗保健，使其与各个社区的背景相适应。提出了一套原则来支持社区素养的发展。描述了针对卫生人员的三个层次的社区素养教育，这些教育与针对消费者的健康素养教育相一致。有人提出，社区素养教育可以促进变革性的社区参与。从高级管理人员到一线临床工作人员的卫生人员所获得的技能，也可以为个人促进健康素养提供更多机会。
将健康素养和社区素养相结合提供了一个整体框架，有可能有效地应对澳大利亚农村和偏远社区及其医疗保健需求和期望的多样性。在更广泛地推广之前，需要进一步研究、验证和评估这三个层次的社区素养教育及其与卫生政策的一致性。
