Table 1.

The 8 guiding principles of the Ophelia (Optimizing Health Literacy and Access) process^*.

Principle	Description
P1. Outcomes focused	Improved health and reduced health inequities
P2. Equity driven	All activities at all stages prioritize disadvantaged groups and those experiencing inequity in access and outcome
P3. Co-design approach	In all activities at all stages, relevant stakeholders engage collaboratively to design solutions
P4. Needs-diagnostic approach	Participatory assessment of local needs using local data
P5. Driven by local wisdom	Intervention development and implementation is grounded in local experience and expertise
P6. Sustainable	Optimal health literacy practice becomes normal practice and policy
P7. Responsiveness	Recognize that health literacy needs and the appropriate responses vary across individuals, contexts, countries, cultures, and time
P8. Systematically applied	A multilevel approach in which resources, interventions, research and policy are organized to optimize health literacy

P, Principle.

^*Adapted from Beauchamp et al. Table 1, p. 5 (26).