Background: Health literacy (HL) is a key competence in people's dealing with health and the health system. This is especially true for people with chronic diseases. Here, there is a great need for adapted interventions not only at the individual level, but especially in organizational and navigational HL areas with the involvement of health professionals. To develop, test and evaluate appropriate interventions based on theoretical concepts, scientifically qualified professionals are essential. 

Objectives: To contribute to the development of a holistic approach to chronic disease-specific HL research and practice, a 3-year multicenter, German-based doctorate programme was established, funded by the Robert Bosch Foundation.

Methods: Scholarship holders (n=12) 1) build a common understanding about central elements of chronic disease-specific HL research via training with (inter-)national experts and continuous peer-exchange, 2) refine their projects along structured internal and external feedback and according to the overall research framework, and 3) train to become HL advocates by ongoing subject-specific training, e.g., regarding HL measurement (research) or intervention planning (practice). In terms of content, research projects are arranged and (re-)formulated around eight overarching, pre-defined research domains from theory development to curriculum-based HL training, based on recommendations by the German National HL Action Plan.

Results: The topics, chosen and adapted by the doctoral candidates, cover a range of research areas, i.e., analysis and adaptation of written health information, measurement of disease-specific individual health literacy, pilot development of case-specific HL interventions, and the assessment of and recommendations for current organizational approaches towards improving HL, e.g. in hospitals and health insurances. Therefore, and based on current conceptual understandings about HL, these contents are embedded in the continuum from personal to situational and social HL determinants, from theoretical understandings to practical application, and from knowledge to action.   

Discussion: Conducting a multifaceted doctorate research programme on HL requires constant adjustment of the single research projects, so that the overall programme suits HL research and practice needs. Our experience so far shows that it is particularly important to cover the spectrum of theoretical, methodological, and content-wise approaches to HL research to contribute to a holistic support model for chronically ill people.