{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:58:15Z","timestamp":1787763495983,"version":"build-2784847793"},"reference-count":13,"publisher":"CSIRO Publishing","issue":"3","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":2557,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,5]]},"abstract":"<jats:p>Evidence exists for the association between health literacy and heart health outcomes. Cardiac rehabilitation is critical for recovery from heart attack and reducing hospital readmissions. Despite this, &amp;lt;30% of people participate in a program. Significant patient, hospital and health system challenges exist to improve recovery through increased heart health literacy. This brief case study reflects and documents practice-based initiatives by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. Three key initiatives, namely the Six Steps To Cardiac Recovery resource, the Love Your Heart book and the nurse ambassador program, were implemented informed by mixed methods that assessed need and capacity at the individual, organisational and systems levels. Key outcomes included increased access to recovery information for patients with low health literacy, nurse knowledge and confidence to engage with patients on recovery information, improved education of patients and improved availability and accessibility of information for patients in diverse formats. Given the challenges involved in addressing heart health literacy, multifaceted practice-based approaches are essential to improve access to recovery information for patients with low literacy levels.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>What is known about the topic?<\/jats:title>\n                    <jats:p>Significant challenges exist for patients with lower health literacy receiving recovery information after a heart attack in hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What does this paper add?<\/jats:title>\n                    <jats:p>This case study provides insights into a practice-based initiative by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What are the implications for practitioners?<\/jats:title>\n                    <jats:p>Strategies to improve recovery through increased heart health literacy must address the needs of patients, nursing staff and the health system within hospitals. Such strategies need to be multifaceted and designed to build the capacity of nurses, heart patients and their carers, as well as support from hospital management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/ah17270","type":"journal-article","created":{"date-parts":[[2018,5,28]],"date-time":"2018-05-28T23:16:51Z","timestamp":1527549411000},"page":"323-327","source":"Crossref","is-referenced-by-count":4,"title":["Improving access to important recovery information for heart patients with low health literacy: reflections on practice-based initiatives"],"prefix":"10.1071","volume":"43","author":[{"given":"Lucio","family":"Naccarella","sequence":"first","affiliation":[{"name":"AThe University of Melbourne, Centre for Health Policy, Melbourne School of Population and Global Health, Level 4, 207 Bouverie Street, Carlton, Vic. 3053, Australia."},{"name":"CCorresponding author. Email: l.naccarella@unimelb.edu.au"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catuscia","family":"Biuso","sequence":"additional","affiliation":[{"name":"BHeart Foundation, Melbourne, Victoria, Australia. Email: catuscia.biuso@heartfoundation.org.au"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Jennings","sequence":"additional","affiliation":[{"name":"BHeart Foundation, Melbourne, Victoria, Australia. Email: catuscia.biuso@heartfoundation.org.au"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Patsamanis","sequence":"additional","affiliation":[{"name":"BHeart Foundation, Melbourne, Victoria, Australia. Email: catuscia.biuso@heartfoundation.org.au"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2018,5,29]]},"reference":[{"key":"2025121500473989800_R1","unstructured":"Barrett SE, Puryear JS, Westpheling K. Health literacy practices in primary care settings: examples from the field. The Commonwealth Fund. 2008. Available at: http:\/\/www.commonwealthfund.org\/~\/media\/files\/publications\/fund-report\/2008\/jan\/health-literacy-practices-in-primary-care-settings--examples-from-the-field\/barrett_hltliteracypracticesprimarycaresettingsexamplesfield_1093-pdf.pdf [verified December 2016]."},{"key":"2025121500473989800_R2","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1471-2458-12-80","article-title":"Health literacy and public health: a systematic review and integration of definitions and models.","volume":"12","author":"S\u00f8rensen","year":"2012","journal-title":"BMC Public Health"},{"key":"2025121500473989800_R3","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1111\/j.1525-1497.2006.00591.x","article-title":"Factors associated with medication refill adherence in cardiovascular-related diseases: a focus on health literacy.","volume":"21","author":"Gazmararian","year":"2006","journal-title":"J Gen Intern Med"},{"key":"2025121500473989800_R4","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1016\/j.annemergmed.2010.08.035","article-title":"Health literacy and emergency department outcomes: a systematic review.","volume":"57","author":"Herndon","year":"2011","journal-title":"Ann Emerg Med"},{"key":"2025121500473989800_R5","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.hrtlng.2010.05.021","article-title":"Adequate health literacy is associated with higher heart failure knowledge and self-care confidence in hospitalized patients.","volume":"39","author":"Johnson","year":"2010","journal-title":"Heart Lung"},{"key":"2025121500473989800_R6","doi-asserted-by":"publisher","first-page":"1174","DOI":"10.1007\/s11606-013-2394-4","article-title":"Low literacy is associated with increased risk of hospitalization and death among individuals with heart failure.","volume":"28","author":"Wu","year":"2013","journal-title":"J Gen Intern Med"},{"key":"2025121500473989800_R7","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1177\/0017896914522029","article-title":"Health literacy predicts cardiac knowledge gains in cardiac rehabilitation participants.","volume":"74","author":"Mattson","year":"2015","journal-title":"Health Educ J"},{"key":"2025121500473989800_R8","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1080\/10810730.2013.829538","article-title":"Health literacy practices and educational competencies for health professionals: a consensus study.","volume":"18","author":"Coleman","year":"2013","journal-title":"J Health Commun"},{"key":"2025121500473989800_R9","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1080\/10810730.2011.604389","article-title":"Knowledge and perceptions of health literacy among nursing professionals.","volume":"16","author":"Macabasco-O\u2019Connell","year":"2011","journal-title":"J Health Commun"},{"key":"2025121500473989800_R10","unstructured":"Brach C, Dreyer B, Schyve P, Hernandez LM, Baur C, Lemerise AJ, Parker R. Attributes of a health literate organization. Washington DC: Institute of Medicine; 2012. 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