What are the challenges faced by GPs in applying evidence-based tools that improve health literacy in economically deprived populations?

Abstract (English)

BACKGROUND: Health literacy (HL) is a key determinant of patient outcomes, yet implementing HL techniques in primary care is particularly challenging in socioeconomically deprived populations. Understanding GP perspectives is essential to inform effective strategies. AIM: This study explored the barriers and facilitators to implementing HL techniques for patients from deprived backgrounds in general practice. METHOD: We conducted 21 semi-structured interviews with GPs across the UK, using purposive sampling to capture diverse practice settings. Data were analysed using the Gioia methodology to generate first-order codes, second-order themes, and aggregate dimensions. RESULTS: GPs recognised the importance of HL but reported significant barriers to consistent implementation. Key challenges included time pressures, lack of training, and the complexity of balancing HL adaptations with clinical demands. Socioeconomic deprivation exacerbated these difficulties, with patients often facing compounding challenges such as language barriers, limited health system navigation, and competing priorities. Despite these barriers, some GPs highlighted strategies that supported HL integration, including simplification of language, visual aids, and continuity of care. Thematic analysis generated aggregate dimensions of structural constraints, practitioner capability, and patient-centred adaptations. CONCLUSION: While GPs value HL techniques, systemic and contextual barriers limit their practical application, particularly in deprived settings. Addressing these barriers requires investment in training, resources, and structural support to enable consistent HL practice. Improving HL in general practice could enhance equity of care and reduce health disparities.