TABLE 1.

Reported context items (C), mechanisms (M) and outcomes (O)

Construct a	Explanation
Context items (C)
Equip HCPs with the right knowledge and skills by means of professional training and education.	Training of skills concerning verbal and non‐verbal communication; ‘shared decision‐making’‐related communication; intercultural communication; tailored communication; interpersonal capacities; providing person‐centred care; to build trustful relationship with patients; empathic skills. Knowledge of medical affairs, diseases and disease processes, social and cultural differences, cultural competences. The specific knowledge and skills necessary for patients with low health literacy skills need to be included as part of the medical education.
Have a good collaboration/team	Multidisciplinary teamwork; effective interprofessional collaboration; collaboration between different domains (e.g. social domain); collaboration between patient and HCPs.
Provide patient education	Promote and provide education/educational information to patients.
Foresee in sufficient time during consultation	Lack of time is often experienced during consultations to approach patients in a holistic wat and address psychosocial problems; limitations of time affect physician‐patient relationship.
Patients having social support (networks)	Social support and social support networks, environmental support, more social support reduced sense of isolation and increased motivation and confidence.
Set up a personalised care planning	Personalised care planning in collaboration with patients (preparation, goal setting, action planning, documenting, coordinating, supporting, reviewing).
Foresee in the required capacity	Creating space for required time, people and resources and using this in a targeted manner to design person‐centred care; sufficiently equipped to accommodate the biopsychosocial needs of patients; availability of sufficient women clinicians for female patients; appropriate and effective use of healthcare resources.
Applying IT‐ and e‐health initiatives	Applying IT‐ and e‐health initiatives; providing telehealth, teleconsultations, and telemonitoring; the use of online tools and technology; developing ICT to access audiotapes of consultations and patient‐held records.
Need for shifting away from the dominance of biomedical approach in medical encounter	Too much focus on disease‐oriented and complaint‐oriented approach; too much focus on what is measurable and outcomes rather than what is necessary; evidence‐based medicine leaves limited room for patient's own considerations; current medical practice strongly based on scientific guidelines.
Accessibility of care	Offering appropriate and preferred access to care, that is care that is conveniently located for the patient (e.g. decentralised services, availability of transportation), and that can be accessed in time. It also includes accessibility to specialists or speciality services when a referral is made and (digital) access to information about care and computerised records.
Have a supporting policy in place	Policy should structurally take into account (patients with) low health literacy skills, social and cultural differences.
Mechanisms (M)
Provide effective communication	HCPs need to provide effective communication by being compassionate, being empathetic, learning about their patients' situations through careful listening and observation, use easy language (avoid medical jargon), conveying tailored and accessible information/materials, checking the patient's understanding of the information and his or her reactions to it, deploying an interpreter.
Have a holistic focus	Understanding the whole person in addition to the presenting illness, treating the patient as a person and not a disease, nonmedical issues are considered relevant, supporting patients in their physical, psychological, social and existential needs, paying attention to the patient's life story, taking into account socio‐economic health differences.
HCPs showing respect and having an open and empathic attitude	Having an open, friendly, empathic attitude with genuine interest in and compassion for the patient. HCP needs to respect the patient's beliefs, preferences, and values, and treat them with dignity.
Patients having an active role in their care process	Engage, support, involve and empower patients to play an important active role in their care process to improve health outcomes; patient participation; involvement patient's families and informal caregivers; encourage people to use question prompts to help them interact; having family support programmes; help create awareness for the patient, explore resilience and take a step in the direction he or she wants.
Establishing a therapeutic relationship	Establishing a longitudinal doctor–patient relationship, invest in therapeutic partnership building, mutual trust.
Provide self‐management support	Provide, empower, enable self‐management (support and education) to patient.
Apply shared decision‐making	Seeking the patient's implicit or explicit involvement in the decision‐making process; exploring the patient's ideas, fears and expectations about the problem and possible treatments; providing a balanced view in the discussion of healthcare options; determine treatment goals together.
Ensure care coordination	Care that is planned and coordinated across health carers, situations, time, and across all elements of the health system; structuring service organisation to enable care continuity.
Outcomes (O)
Health outcomes	Improvements in physical health, functional outcomes, and clinical outcomes (e.g. blood glucose levels, lung function, haemoglobin, cholesterol and blood pressure).
Patient involvement	Increased self‐efficacy, higher participation in shared decision‐making, enhanced patient autonomy.
Health system outcomes	Less referrals, less follow‐up examination, reduced emergency department visits, reduced hospital (re)admissions.
Satisfaction	Higher satisfaction of patient, informal caregiver and/or healthcare providers.
Concordance	Higher treatment and medication concordance; improved health behaviour of patient.
Self‐management skills	Improvements in self‐management skills/capabilities/activities and self‐management outcomes.
Psychological outcomes	Improvements in psychological health (e.g. depression, anxiety and distress).
Treatment approach	Improved patient‐centred treatment approach, right intensity of support, more appropriate treatment, better connection of care for people with low health literacy skills.

^a Items shown in ascending order of how often they were reported in the literature.