September 9, 2026 · Executive evidence brief
Health Empowerment Day 2026: Make Access and Follow-Through Visible
Use the observance to test whether people can find care, understand their options, participate in decisions, complete the next step, and receive support when the standard pathway does not work.
Leadership signal
Empowerment is a condition the care system helps create
Health Empowerment Day can easily become a list of things people should do: schedule a screening, prepare questions, compare options, seek a second opinion, use a portal, take medications correctly, or follow up after discharge. Those actions may be useful. Yet a message framed only around personal responsibility can hide the work required of the organization. A person cannot choose among options that were not explained. They cannot complete a referral that no receiving service acknowledges. They cannot use a digital tool that is inaccessible, unfamiliar, unaffordable, or unavailable in their language. They cannot follow instructions that conflict, arrive too late, or assume resources they do not have.
For executives, empowerment is therefore not a personality trait to demand from patients. It is a practical result of access, understandable communication, respectful relationships, meaningful choice, navigation, continuity, and the ability to revise a plan when circumstances change. A capable person may still be blocked by a fragmented system. A person who needs support today may be highly independent tomorrow. Good operations make room for that variation without labeling one level of participation as morally superior.
The research also cautions against treating “informed choice” as a simple, universally measured endpoint. An umbrella review of 16 systematic reviews found no consensus about how informed choice should be defined or measured. The authors recommended standardized, validated, multidimensional approaches grounded in theory and informed by patients across diverse populations. The underlying reviews used heterogeneous definitions, many had a high risk of bias, and the synthesis was narrative. Leaders should not turn one survey item, a signed form, or a portal click into proof that a person understood the options or made a choice aligned with their values.4
Patient activation research offers another useful boundary. In a randomized care-management trial of 1,387 Medicaid or dually eligible adults with multiple chronic conditions, a high-touch model improved patient activation by an adjusted 2.69 points at 12 months compared with a telephonic option. It did not improve the primary outcome of 90-day readmission. The lesson is not that activation is unimportant. It is that a proximal measure of knowledge, confidence, or skill should not be presented as if it guarantees a clinical or utilization outcome. Leaders need a chain of measures that distinguishes what the organization delivered, what the person experienced, what action occurred, and what happened afterward.5
Evidence pattern
Participation improves when design moves beyond passive information
Patient decision aids provide one window into how design choices influence knowledge and informed participation. A network meta-analysis of 209 randomized trials examined attributes of patient decision aids; 149 trials were eligible for at least one outcome network. Decision aids without probabilities were associated with poorer knowledge than aids that presented probabilities. Delivering an aid during the consultation rather than before it was also associated with poorer knowledge and more uninformed values. Involving patients in development was associated with higher knowledge. These estimates came from indirect network comparisons, not head-to-head trials of each design attribute, so they should guide careful testing rather than establish a universal formula.8
The operational message is concrete. Information should arrive early enough to be considered, present uncertainty and probability in a usable way, and be designed with the people expected to use it. A technically accurate handout may still fail if it arrives after the decision, uses unfamiliar risk formats, assumes English fluency, or omits the practical consequences people care about. The appropriate standard is not whether content exists. It is whether the intended audience can use it in the real decision context.
Figure 1 · Evidence chart
Selected decision-aid attributes and knowledge outcomes
Teach-back is another example of an apparently simple practice whose evidence needs careful interpretation. A systematic review of teach-back for chronic kidney disease education included six studies with 520 participants. The review found some evidence of improvements in self-management, self-efficacy, and knowledge, but limited evidence for psychological outcomes and quality of life. Heterogeneity prevented meta-analysis. Leaders can treat teach-back as a communication method worth implementing and monitoring, but not as a guarantee that comprehension, adherence, or outcomes will improve in every population and setting.11
A broader systematic review of 10 randomized outpatient trials targeting health literacy or patient activation found that people with lower baseline literacy or activation were most likely to benefit. Moderate improvements translated into some gains in physical activity and mental health, but not into consistent improvement in quality of life or healthcare utilization. The review called for longer-term evidence. This pattern argues for proportionate support: provide a universally understandable pathway, then add tailored assistance based on the barriers and preferences identified with the person.14
These findings support three leadership controls. First, define the intended decision or action rather than distributing general information without a route. Second, test whether people can understand and use the material before it is released at scale. Third, connect information to a person, team, or service that can answer questions and own the next step. Content, conversation, and continuity are different capabilities; an empowerment strategy needs all three.
Visible pathway
Turn a recommended action into an acknowledged sequence
Healthcare pathways often depend on invisible work. People compare appointment times, arrange transportation, seek time away from work, find childcare, translate instructions for family members, locate records, reconcile bills, and decide when a symptom warrants escalation. Staff members call offices, resend referrals, repeat education, search for community resources, and manually bridge systems that do not communicate. If those tasks are not represented in the pathway design, failure is likely to be attributed to the person who could not complete them.
The organization should begin with a bounded journey, such as completing a preventive screening, choosing among treatment options, starting a new medication, accessing rehabilitation, or moving from hospital to home. Map the route from the person’s first intention to a closed loop. Every handoff needs a sending role, a receiving role, an acceptance signal, an expected interval, an escalation route, and a documented closure condition. “Referral placed” is not the same as “referral received,” and neither is the same as “care completed.”
Figure 2 · Process flow
The minimum empowerment pathway
- AccessOffer a clear entry point, language access, accommodations, cost information, and non-digital alternatives.
- UnderstandExplain the issue, options, benefits, harms, uncertainty, and what happens next in usable language.
- DecideElicit priorities, preferred participation, and the choice to proceed, pause, decline, or revisit.
- ActBook, refer, prescribe, teach, or connect while ownership remains explicit.
- Follow upConfirm receipt, identify barriers, reconcile changes, and escalate unresolved needs.
- LearnUse outcome, experience, and equity signals to improve the route without blaming the person.
The sequence also prevents a common category error: equating a decision with follow-through. A person may make an informed choice but be unable to obtain the service. Another person may complete a task without understanding why it was recommended. A third may prefer to delegate parts of the decision to family or a trusted clinician. Measurement should distinguish these situations rather than collapse them into one label such as “engaged” or “noncompliant.”
Qualitative evidence helps leaders identify where a locally specific pathway may break. A systematic review focused on breast cancer screening and treatment in underserved U.S. communities found recurring barriers involving patient-provider communication, cultural, religious, or language factors, and social determinants. Because the review is disease-specific and its coding reflects the included literature, the frequency of themes should not be treated as population prevalence. The themes are useful prompts for local listening, not a substitute for it.1
A qualitative systematic review of community-health-worker and peer-supported interventions for ethnic minorities with type 2 diabetes reported that trust, cultural sensitivity, practical content, confidence, and social support shaped acceptability. Time, transportation, work, childcare, and resource limitations could impede participation. Again, these are qualitative themes, not effect sizes. They remind improvement teams to ask about the practical conditions around the pathway rather than assuming that an educational deficit is the primary cause of a missed step.12
Figure 3 · Qualitative fishbone
Hypotheses to test when follow-through breaks
Digital inclusion
A portal is an access channel, not proof of access
Digital tools can make appointments, messages, results, education, and care plans easier to reach. They can also move work onto patients without ensuring that people have the device, connectivity, language, accessibility, time, identity documents, or confidence needed to succeed. An equitable digital strategy preserves non-digital routes, reduces avoidable enrollment friction, and provides help at the moment a person needs to complete a real task.
A systematic review and meta-analysis of 17 studies found patterned differences in hospital patient-portal use. Women were 16% more likely to use portals than men, people with higher education were 37% more likely than those with lower education, employed people were 23% more likely than unemployed people, and married people were 13% more likely than unmarried people. Findings related to income were inconsistent. These are associations across heterogeneous studies, not evidence that demographic traits cause use or that any one intervention will close a gap. They do establish that aggregate adoption can conceal unequal participation.7
Workflow design can change that pattern. An interrupted time-series analysis of an automatic-enrollment intervention reported steeper activation trends for Latinx, Black, and Asian patients relative to the trend among White patients, and a much larger relative trend for people whose preferred language was not English compared with English. The intervention increased activation but did not eliminate disparities. Because the study came from one system and was not randomized, leaders should interpret it as evidence that enrollment defaults and workflow matter, not as a guaranteed causal effect in every organization.10
Interviews with 31 adults age 60 or older during the COVID-19 pandemic add the lived-experience layer. Rapid or forced portal adoption sometimes bypassed the gradual development of intention and confidence, creating difficulty even when access technically existed. The authors recommended tailored training. The qualitative sample and pandemic context limit generalizability, but the message is durable: activation counts do not show whether a person can use the tool safely and independently for the task at hand.3
Executives can act on this evidence without assuming every person should become a high-frequency portal user. Define the essential tasks the channel is meant to support. Observe people completing those tasks with consent and privacy safeguards. Measure where they abandon the process. Offer training tied to an immediate need, such as viewing a result or confirming an appointment, rather than a generic tour. Monitor help requests, identity-proofing failures, message-response time, proxy access, accessibility defects, language mismatch, and the availability of telephone or in-person routes.
Most importantly, do not shift accountability for system latency onto the patient. If a message sits unread in an organizational queue, more portal reminders will not fix the ownership defect. If online appointments exclude certain services, a high portal activation rate may coexist with poor access. If automated content is not understandable, volume can grow while comprehension falls. The channel should make a pathway easier; it should not become a gate that determines who is considered engaged.
Follow-through
Support must continue after the decision and beyond discharge
Transitions expose the difference between information and participation. A discharge conversation may be respectful and thorough, yet the plan can fail when medications are unavailable, symptoms evolve, home support is limited, appointments are difficult to schedule, or no one reconciles conflicting instructions. Empowerment at a transition means that the person knows what to do, can do it, knows whom to contact, and receives a response when the plan changes.
A mixed-methods systematic review of 25 studies reported in 29 papers examined patient-engagement interventions for medication management among older adults across transitions of care. Seventy-six percent of the interventions used passive, lower-level engagement, while 24% involved higher-level partnership. Higher-level interventions consistently improved long-term outcomes in the included evidence but required more resources, and interventions extending beyond discharge were more likely to achieve lasting outcomes. The review’s categories and heterogeneous designs limit simple comparison, yet the direction is useful: asking patients to receive information is different from involving them in medication decisions and ongoing problem solving.2
Automation can extend reach, but engagement metrics need interpretation. A systematic review of 13 studies involving 34,386 medical and surgical patients found completion rates of 44% to 56% for automated calls and response rates as high as 87% for text messages. Evidence of improved clinical outcomes was limited and inconclusive. A completed call or text response shows contact with the tool, not necessarily comprehension, problem resolution, or improved health. Automated follow-up is best treated as one layer in a tiered system with timely human review and a route for people who do not respond.6
High-touch support may improve a proximal capability while leaving a harder endpoint unchanged, as the randomized care-management trial of adults with multiple chronic conditions demonstrated. That distinction protects organizations from overstating success. An intervention can be worthwhile because it improves confidence, experience, understanding, or access even when a utilization endpoint does not change. The dashboard should display those measures separately and preserve the primary trial result.5
Community health workers can help bridge clinical and practical realities. A systematic review of 26 U.S. studies focused on rural populations found that community health workers most often delivered health education, linked people with community resources, or combined those functions. Nearly all studies reported positive outcomes, and positive return on investment was reported where it was assessed. Most designs were nonrandomized and interventions were heterogeneous; only 30% described integration of the community health worker into the care team. Leaders should not assume that adding a role will automatically improve access. Recruitment, training, supervision, caseload, documentation, payment, information sharing, community legitimacy, and authority within the clinical team determine whether the bridge is usable.13
A safe tiered follow-up model can begin with the least burdensome channel preferred by the person, use clear rules to identify unanswered or concerning responses, and assign an accountable human owner. The organization should test the route for people who lack stable telephone or internet access, use a proxy, speak a language not supported by the automated system, have hearing or vision access needs, or decline digital contact. Nonresponse is a signal of uncertainty, not evidence of refusal.
Operating system
Move empowerment from a campaign message into organizational infrastructure
Organizational health literacy reframes the work. Instead of asking only whether individuals can read and act on health information, it asks how consistently the organization makes information and services easier to find, understand, and use. A 2025 systematic review included 62 articles from 15 countries published from 2010 through 2024. Almost one-third concerned tool development or validation, while the rest spanned qualitative, descriptive, case-study, cross-sectional, mixed-methods, and quantitative designs. The authors emphasized organizational support, structural adaptation, and resources. The heterogeneity means there is no single universal implementation recipe, but it reinforces that clarity is a governance and operations responsibility, not only a writing standard.9
A scoping review of 24 descriptive studies identified leadership support, a combined top-down and bottom-up approach, a champion, and staff commitment as critical implementation factors. Nine of 13 intervention studies reported improvements in areas such as understandable communication, workforce competencies and practices, or strategic change, while evidence for patient outcomes was scarce. Organizations can therefore measure implementation progress without claiming that improved materials or training alone produced a health outcome.15
Figure 4 · Operating-system diagram
Six capabilities that make participation usable
Foundation: compensated patient and community partnership, capable workforce, sustainable financing, interoperable information, and equity-aware measurement.
The six capabilities should be built around a specific service route. Leadership sets the aim and protects resources. Communication teams make information usable. Clinical teams create a decision process that can reflect values and uncertainty. Navigators help solve logistical barriers. Digital teams make channels inclusive. Transition owners close loops and bring defects into review. Patients and community partners should participate across the system, not be invited only to approve finished materials.
Governance should also define what empowerment is not. It is not abandonment under the language of autonomy. It does not require a person to manage every detail without assistance. It is not persuasion toward the organization’s preferred choice. It is not unlimited choice when options are clinically inappropriate or unavailable. It is not surveillance of behavior without transparent purpose and consent. And it is not an excuse to withhold navigation because information was technically accessible.
A practical governance charter can specify the population and pathway, the decision rights of the improvement team, the role of clinical and community expertise, the handling of urgent safety concerns, the rules for small-group reporting, and the conditions for expansion. Leaders should identify who can change scheduling templates, translation workflows, portal defaults, referral agreements, staffing coverage, or vendor configurations. Without those authorities, the team may repeatedly document barriers it cannot remove.
Measurement
Use a chain of evidence, not one engagement score
A useful measurement system separates at least four questions. Did the organization deliver the intended support? Could the person understand and use it? Did the intended next step occur? What outcome or experience followed? A fifth question examines equity: where do process, experience, or outcome signals vary, and are the data sufficiently complete and safe to interpret?
Process measures can include time to acknowledged referral, availability of an interpreter or accommodation, completion of teach-back when appropriate, decision-aid delivery before the consultation, successful portal enrollment, response to an escalated message, medication reconciliation, or documented follow-up after discharge. These measures reveal the reliability of an organizational action. They do not prove informed choice, adherence, or improved health.
Experience measures can ask whether people felt heard, understood the options, could ask questions, knew the next step, knew whom to contact, and received care consistent with their priorities. Survey items should include an opportunity to report pressure, dismissal, confusion, or unwanted responsibility. Qualitative follow-up can reveal mechanisms that a rating scale misses, but leaders should not generalize a small sample into prevalence.
Outcome measures depend on the pathway. They may include completion of a screening, medication access, attendance at rehabilitation, resolution of an unanswered question, avoidable delay, confidence with a task, or a clinically appropriate endpoint. Balancing measures matter: staff workload, message burden, delayed care elsewhere, false reassurance, unwanted contacts, privacy incidents, digital lockout, and community-partner capacity can expose harm created by an otherwise promising change.
Figure 5 · Structured control table
From empowerment tactic to accountable measurement
| Operational tactic | Accountable owner | Process signal | Outcome or experience signal | Balancing signal | Equity cut |
|---|---|---|---|---|---|
| Decision aid before consultation | Service-line clinical and access leads | Eligible encounters receiving the aid before the visit | Understanding, values clarity, preferred participation | Visit delay, unwanted burden, conflicting information | Language, disability, site, payer, digital versus paper route |
| Teach-back for a priority task | Clinical operations and education | Appropriate encounters with documented teach-back | Ability to explain or demonstrate the next step | Staff time, shame or discomfort, inappropriate scripting | Language, age, literacy support requested, care setting |
| Low-friction portal enrollment plus coaching | Digital front door and patient access | Activation and successful completion of one intended task | Task confidence, successful access, problem resolution | Lockouts, privacy concerns, help volume, lost non-digital access | Race and ethnicity, preferred language, age, disability, geography |
| Acknowledged referral handoff | Sending and receiving service owners | Referral acceptance within a locally defined interval | Completed or preference-concordantly declined next step | Duplicate work, queue growth, inappropriate referrals | Site, service, language, payer, geography, referral channel |
| Tiered post-discharge follow-up | Transition-care lead | Contact, response, escalation, and human resolution | Plan understanding, medication access, resolved concern | Alert fatigue, unwanted contact, delayed escalation | Channel, language, age, disability, connectivity, proxy use |
| Community health worker support | Population health and community partner | Reach, warm connection, closed-loop resource referral | Access, trust, self-efficacy, resolved practical barrier | Caseload, turnover, uncompensated work, role confusion | Rurality, language, neighborhood, payer, referral source |
Stratification should be chosen with the people affected and used to examine the system, not stereotype a group. A difference by race, language, geography, payer, age, or disability does not identify the cause. It signals where the team should examine exposure to the intervention, data completeness, service availability, communication, historical trust, and practical barriers. Small numbers may require suppression, aggregation, longer observation, or qualitative learning rather than a public rate.
The data-quality note belongs beside the dashboard. It should define the eligible population, missing data, exclusions, known workflow gaps, and the difference between activity and outcome. For example, a portal message marked delivered may not have been read; an automated call completed may not have resolved a concern; a referral accepted may not have led to an appointment; and a decision recorded may not reflect informed values. Review should focus on what can be improved, what remains uncertain, and what might have been harmed.
Set no target merely because the field is easy to count. A target for universal portal use can conflict with channel choice. A target for one particular treatment decision can undermine autonomy. A target for rapid referral closure can encourage inappropriate closure codes. Choose measures that protect informed participation, timely service, and transparent follow-through, then pair them with balancing signals that make gaming and unintended effects visible.
90-day plan
Use the observance to remove one visible barrier
A 90-day cycle can convert Health Empowerment Day from a campaign into a bounded operational commitment. The interval is a management device, not a clinical timeline. Urgent safety, access, legal, privacy, or regulatory concerns should move faster. The goal is to select one important pathway, learn with the people who use and operate it, test a feasible change, and establish ongoing ownership.
Figure 6 · Gantt timeline
30/60/90-day implementation sequence
Days 1–30: listen, define, and map
Name an executive sponsor, operational owner, clinical lead, access or digital lead, community-partner lead, and data lead. Define one population and one observable journey. Good candidates have a meaningful barrier, a manageable boundary, available authority, and a plausible measure. Avoid a project defined as “increase empowerment” without specifying the action and pathway.
Invite patients, care partners, frontline staff, interpreters, navigators, and community organizations to describe the route. Compensate community expertise when appropriate, provide accessible participation options, protect privacy, and make clear which decisions the group can influence. Observe the work where possible. What looks like a knowledge problem in a conference room may be a scheduling rule, inaccessible form, unreturned call, unaffordable medication, transportation constraint, or conflicting ownership at the point of care.
Map each step, queue, handoff, failure state, workaround, and escalation. Identify where the person must supply information the organization already has, where a digital identity check fails, where language or accommodation support disappears, where advice conflicts, and where no one confirms the next step. Establish a baseline using a small set of process and experience signals. Record missingness and interpretation limits.
Days 31–60: co-design, simulate, and test
Select one barrier with the people affected. Define the countermeasure, owner, intended mechanism, measure chain, and balancing signals. If the change is a decision aid, test timing, probability format, reading demand, language, accessibility, and the route to a human conversation. If it is portal enrollment, test task completion and recovery from failure, not only activation. If it is a referral workflow, define acceptance, escalation, and closure. If it is community navigation, define authority, supervision, compensation, caseload, documentation, and information sharing.
Simulate the workflow before live use. Include a person who needs an interpreter, uses a proxy, lacks a portal account, has limited transportation, cannot answer during business hours, changes their mind, or needs urgent clinical escalation. Simulation cannot represent every reality, but it can expose hidden assumptions. Correct safety and privacy defects before the test.
Test in at least two representative conditions when feasible, such as weekday and weekend, digital and telephone, hospital and ambulatory, English and another locally common language, or one high-resource and one lower-resource site. Use brief huddles to review failures without blame. Ask whether the intervention reached the intended population, whether people could use it, whether staff had capacity, and whether a workaround shifted burden elsewhere.
Days 61–90: implement, review, and sustain
Move from test to bounded implementation only after a readiness check. Confirm training, staffing, coverage, accessibility, translation, privacy, escalation, documentation, partner agreements, and data capture. Communicate the change in a way that does not promise more than the pathway can deliver. An invitation to take action should point to a functioning route.
Review the measure chain at a cadence matched to risk. Examine unresolved cases, not just averages. Pair quantitative signals with protected qualitative feedback. Report what changed, who was reached, what did not work, what remains uncertain, and what the organization will do next. If an outcome did not change, do not relabel a process improvement as clinical effectiveness. If a subgroup gap appears, investigate the system conditions before proposing an explanation.
At day 90, governance should decide whether to adopt, adapt, expand, or stop the change. Continued operation requires a named owner, budget, workforce capacity, technology support, community-partner arrangement, documentation standard, measure definitions, privacy safeguards, and review date. Expansion should depend on evidence that the workflow can be delivered reliably in the next setting, not only enthusiasm generated by the observance.
Leadership close
Make the next step understandable, reachable, and owned
Health empowerment becomes credible when people can act without having to compensate for invisible organizational defects. The evidence does not support a single universal intervention or one summary score. It supports a connected approach: usable information before a decision, participation that reflects personal values, digital routes designed for inclusion, human support for practical barriers, acknowledged handoffs, follow-up beyond discharge, and measurement that distinguishes activity from outcome.
The most meaningful observance result is not the number of impressions, downloads, or portal invitations. It is whether the organization found a real barrier, shared authority with people affected by it, changed a workflow or resource condition, and established a transparent way to learn what happened next. Empowerment is not the transfer of responsibility away from the care system. It is the creation of conditions in which people can understand, choose, act, and ask for help while the organization remains accountable for the route.
Peer-reviewed sources
Scholarly references, newest first
All 15 records were individually verified as peer-reviewed scholarly sources through authenticated academic research databases. Private database names and access routes are intentionally omitted. Links resolve through publisher DOI records.
- Mendonca, J., Etzel, M., Eldawy, N., Lent, A., Jimenez, S., Brinzo, P., Kaleem, S., Dean, A., Burgoa, S., Follin, T., Mejia, M., Kitsantas, P., & Sacca, L. (2026). The role of patient–provider communication and social support in improving adherence to breast cancer screening and treatment guidelines among United States underserved communities: A systematic review. Journal of Public Health: From Theory to Practice, 34(6), 1469–1500. https://doi.org/10.1007/s10389-025-02514-0
- Ottosen, K., Garratt, S., Hwang, K., Marconi, G., Wong, P., Kilby, G., Prasad, M., Deery, C., & Manias, E. (2026). Patient engagement interventions to improve medication management of older patients across transitions of care: A mixed methods systematic review. Journal of Clinical Nursing, 35(6), 2622–2644. https://doi.org/10.1111/jocn.70203
- Jeong, C. H., Kim, B., & Bessette, M. (2026). Navigating the digital divide: Utilization of patient portals among older adults during the COVID-19 pandemic in the United States. Qualitative Health Research, 36(6), 565–577. https://doi.org/10.1177/10497323251316194
- Sprosen, H., Re, C., Stewart, G. D., & Usher-Smith, J. A. (2026). Operationalizing and measuring informed choice in health care: An umbrella review. Medical Decision Making, 46(4), 501–526. https://doi.org/10.1177/0272989X251413276
- Williams, K., Kogan, J. N., Markwardt, S., Kang, C., Landsittel, D., Beckjord, E., Karp, J. F., & Swayze, D. (2026). Integrated care for chronic conditions: A randomized care management trial. American Journal of Managed Care, 32(4), 202–210. https://doi.org/10.37765/ajmc.2026.89844
- Trabilsy, M., Genovese, A., Gomez-Cabello, C. A., Haider, S. A., Prabha, S., Collaco, B., Wood, N. G., Bagaria, S., London, J., & Forte, A. J. (2026). Automated discharge instructions in medical and surgical care: A systematic review of patient engagement and clinical outcomes. Healthcare, 14(6), 798. https://doi.org/10.3390/healthcare14060798
- Goldberg, N., Herrmann, C., Di Gion, P., Hautsch, V., Hefter, K., Langebartels, G., Pfaff, H., Ansmann, L., Karbach, U., & Wurster, F. (2025). Sociodemographic and socioeconomic determinants for the usage of digital patient portals in hospitals: Systematic review and meta-analysis on the digital divide. Journal of Medical Internet Research, 27, e68091. https://doi.org/10.2196/68091
- Stacey, D., Carley, M., Gunderson, J., Hsieh, S.-C., Kelly, S. E., Lewis, K. B., Smith, M., Volk, R. J., & Wells, G. (2025). The effect of patient decision aid attributes on patient outcomes: A network meta-analysis of a systematic review. Medical Decision Making, 45(4), 437–448. https://doi.org/10.1177/0272989X251318640
- Pelizzari, N., Covolo, L., Ceretti, E., Fiammenghi, C., & Gelatti, U. (2025). Defining, assessing, and implementing organizational health literacy: Barriers, facilitators, and tools – a systematic review. BMC Health Services Research, 25(1), 599. https://doi.org/10.1186/s12913-025-12775-w
- Milanfar, L., Soulsby, W. D., Ling, N., O’Brien, J. S., Oates, A., & McCulloch, C. E. (2024). Automatic enrollment in patient portal systems mitigates the digital divide in healthcare: An interrupted time series analysis of an autoenrollment workflow intervention. Journal of Medical Systems, 48(1), 94. https://doi.org/10.1007/s10916-024-02114-7
- Jagodage, H. M. H., McGuire, A., Seib, C., & Bonner, A. (2024). Effectiveness of teach-back for chronic kidney disease patient education: A systematic review. Journal of Renal Care, 50(2), 92–103. https://doi.org/10.1111/jorc.12462
- Grant, V., & Litchfield, I. (2024). Acceptability of community health worker and peer supported interventions for ethnic minorities with type 2 diabetes: A qualitative systematic review. Frontiers in Clinical Diabetes and Healthcare, 5, 1306199. https://doi.org/10.3389/fcdhc.2024.1306199
- Berini, C. R., Bonilha, H. S., & Simpson, A. N. (2022). Impact of community health workers on access to care for rural populations in the United States: A systematic review. Journal of Community Health, 47(3), 539–553. https://doi.org/10.1007/s10900-021-01052-6
- Hosseinzadeh, H., Downie, S., & Shnaigat, M. (2022). Effectiveness of health literacy- and patient activation-targeted interventions on chronic disease self-management outcomes in outpatient settings: A systematic review. Australian Journal of Primary Health, 28(2), 83–96. https://doi.org/10.1071/PY21176
- Kaper, M. S., Sixsmith, J., Reijneveld, S. A., & de Winter, A. F. (2021). Outcomes and critical factors for successful implementation of organizational health literacy interventions: A scoping review. International Journal of Environmental Research and Public Health, 18(22), 11906. https://doi.org/10.3390/ijerph182211906