Background. Health literacy (HL) is considered by WHO as one of the three pillars of health promotion and is positively related to health. HL is a dynamic concept that is established in the relationship between citizenship and the resources available in the territory (it is not only linked to individual competences), and that evolves throughout the lifespan. Interdisciplinary in nature, HL needs to be carried out on an ongoing basis.

We aimed at designing and running a short course on HL to make available health education and promotion projects and resources visible, and to generate a framework for discussion and collaboration on HL.

Methods. A MOOC on HL across the lifespan was designed and delivered in Spanish. We used a specific online educational platform (to present the materials) and Twitter (for discussion and sharing). Discussion on Twitter was actively moderated (January to March 2020) through a specific account @MoocSaludUOCX by health education professionals in the hospital setting and used a specific hashtag #alfabeSaludUOC.  

Results. 1226 people registered and 51.4% of them accessed the first module on general aspects of HL. In the end, 256 people participated in all the proposed discussion activities (76.5% women; 78% between 30 and 59 years old) and 386 people regularly followed the @moocSaludUOCX account.

Participants shared about 120 new items related to HL (scientific articles, apps, clinical projects, etc.) and deeply discussed 5 specific topics.  A Twitter list was created at the end of the period. HL was surveyed by using the HLS-EU-Q16. 255 participants responded to the questionnaire pre-MOOC (41%, sufficient HL; 24.45% problematic HL; and 31.37% inadequate HL).  Measures post-MOOC (n=77) showed small improvements.

Conclusions. The open discussion of the course content on Twitter allowed the participation of people who were not enrolled in the MOOC, some of whom were previously followers of the MOOC's authors, their affiliating institution (eHealth Center of the Universitat Oberta de Catalunya), or the facilitators.

The challenge is to maintain a flow of interest and collaboration on the topic as a community of practice. Twitter can be a useful tool for this.