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Abstract Background Health literacy has a strong influence on individual health outcomes and the sustainability of healthcare systems. Healthcare professionals often overestimate patients’ health literacy levels and lack adequate competencies to address limited health literacy effectively. Therefore, promoting understanding through effective health communication between professionals and citizens is becoming increasingly important. Although health literacy has recently gained more attention, health literacy educational programmes targeting future healthcare professionals are still scarce, especially in Europe. This study describes the piloting process of a pan-European health literacy educational programme and shows how the educational material is being used during time of crisis such as the COVID-19 pandemic. Methods The educational programme was developed through the definition of an educational philosophy and iterative co-creation processes consisting of stakeholders’ consultations, material development and pilots with students. The evaluation was carried out in Italy through four pilot tests involving 107 students of health-related degrees. An evaluation questionnaire and a pre-post test were developed and used to collect students’ and educators’ feedback (quantitative and qualitative) and assess changes in health literacy awareness, respectively. Three additional pilots were organized in Italy and Germany mostly during the COVID-19 pandemic to evaluate the feasibility of the educational programme through online and hybrid learning, respectively. Results The pilots received positive feedback from both students and educators. Students were highly satisfied with the courses, reported their relevance for their future profession and appreciated the interactive teaching methods. The pre-post test showed a significant improvement in health literacy awareness after the training. Educators reported the adequacy and flexibility of the training material, the ease of transferability of the content of the lessons into practice, and the validity of the tested options to integrate the educational programme into the curricula. Conclusions Our comprehensive, evidence-based educational programme contributes to addressing the existing challenges in Europe, and its flexibility allows for easy integration in the curricula, through different options, hence supporting a widespread uptake in the European Union and maybe beyond. Health literacy education is a useful tool to improve citizens’ access to healthcare information and services, achieve better health outcomes and support healthcare systems’ sustainability.

Abstract Background Critical health literacy enables older adults to make informed health decisions and take actions for the health and wellbeing of themselves and their community, within their own social and cultural context. A community-based approach has the potential to improve the critical health literacy of older adults and their communities. However, it is not clear how such initiatives consider critical health literacy. Therefore, this study explored how community-based initiatives address the critical health literacy of older adults and their communities. Methods A systematic literature search was conducted. Two reviewers independently screened titles and abstracts, as well as the quality of the methodological and community-based elements of the studies. In addition, a meta-synthesis was carried out, consisting of a qualitative text analysis of the results sections of the 23 included studies. Results We identified two main themes, which are practices that contribute to the critical health literacy of older adults as well as their communities: 1) collaborative learning, and 2) social support. In these practices we identified reciprocity as a key characteristic of both co-learning and social support. Conclusions This study provides the first overview of community-based initiatives that implicitly address the critical health literacy of older adults and their community. Our results demonstrate that in the context of one’s own life collaborative learning and social support could contribute to people’s understanding and ability to judge, sift and use health information. We therefore suggest to add these two practices to the definition of critical health literacy.

Background: The Face up to Frailty campaign is evolving from the EU Joint Action on Frailty ‘A comprehensive approach to promote a disability-free Advanced age in Europe: the ADVANTAGE JA initiative’. Purpose: Our aim is to create the conditions to support the person centred engagement and co-production of a Face up to Frailty campaign with narrative from people who have lived experience of frailty, their families and unpaid carers. Generating messages for use by policy leads, advocates, professionals, and cross sector organisations implementing their frailty approach. This approach has been tested through a workshop in Madrid December 2018with calls to action to contribute to the European campaign which aims to: Raise awareness of the impact of frailty for individuals, families, communities and systems Support people to share their stories about living with frailty Influence policy leaders and commissioners about what they can do to improve lives Help people from all sectors to understand what they can do to prevent and manage frailty Build readiness for a decade of active ageing aligned with the WHO Strategy and action plan Aims and Objectives: The workshop builds on the successful ICIC18 frailty workshop series through ADVANTAGE JA shared learning and legacy building. Workshop participants will be introduced to ADVANTAGE JA and the Face Up to Frailty concept and campaign. We will use interactive world café methodology and appreciative inquiry approach to facilitate small group discussions. Explore how they can develop and share messages, stories and pictures through their frailty development to promote a positive perspective on older people and a better understanding of their wealth of experience and life skills. Participants will have: A space for open, honest, values based reflection on their current engagement with people with lived experience, their families and carers and how this influences their approach to frailty. An opportunity to explore the Face Up to Frailty Campaign and mould to their context. Greater understanding on the approach to engagement and co-production Time for peer learning their engagement experiences, successes and challenges. Opportunity to draft their approach to their Face Up to Frailty action plan / pledge Format (timings, speakers, discussion, group work etc.) 90 minutes workshop Welcome and introductions from session Chair 5m ‘How do you involve the voice of lived experience in your context? 5m ADVANTAGE JA Frailty Roadmap key messages 5m Face Up to Frailty 2m Facilitated group work 40m Commitments to action - Participants will consider how they will apply the learning and share their commitments / develop their Face Up to Frailty pledges 15m Target audience: Policy makers, advocacy groups, organisational leaders and managers, health and social care professionals, regulators, commissioners, patients, unpaid carers as well as researchers engaged in integrated care. Learnings / take away: Understanding of ADVANTAGE JA and Face Up to Frailty approaches and resources: http://advantage/eu Develop their own Face Up to Frailty pledges Practical insight into how to engage and involve people and communities as equal partners Sign up to IFIC Preventing and Managing Frailty Special Interest Group and Integrated Care Matters webinar series.