Introduction: One in three patients with heart failure (HF) has low health literacy. Low health literacy leads to difficulties in understanding the condition, and an increased risk of medication non-adherence and re-hospitalization.

Objective: To develop an intervention targeting access to information and empowerment of low health literacy HF patients using a participatory approach involving key stakeholders. The intervention will be adapted to the local context and to the needs of the patients at the time of discharge from hospital and return home.

Method: We followed the step-by-step Ophelia methodology (Osborne et al. 2013). 1/ We conducted an observational mixed-methods study (cross-sectional survey associated with semi structured interviews) to measure HF patients health literacy level using the Health Literacy Questionnaire (HLQ) and the Brief Health Literacy screening tool, and to identify local strengths and needs. 2/ We designed clinical vignettes based on cluster analysis of the HLQ results and 3/ We organized participative co-construction workshops involving HF patients, caregivers and health professionals to design the intervention based on the clinical vignettes.

Results: The prevalence of low health-literacy was 50.6% among the 106 HF patients surveyed. The cluster analysis classified HF patients into 6 groups based on similar health literacy profiles. Four of the clinical vignettes typical of HF patients with the greatest difficulties were presented during 4 co-construction workshops involving 20 participants (in and out-hospital’s health professionals, patients and caregivers). The levers and obstacles to self-management of the disease for each of the 4 patient profile were identified and the components of the intervention adapted to each type of profile were proposed.

Conclusion: This structured approach makes it possible to build a health intervention fitting the needs and issues of the stakeholders to improve the management of patients with low health literacy level.