Critical health literacy: A review and critical analysis
ABSTRACT Though there has been a considerable expansion of interest in the health literacy concept worldwide, there has also been criticism that this concept has been poorly defined, that it stretches the idea of "literacy" to an indefensible extent and more specifically, that it adds little to the existing concerns and intervention approaches of the better established discipline of health promotion. This paper takes as a starting point the expanded model of health literacy advanced by Nutbeam (2000) and addresses these concerns by interrogating the concept of "critical health literacy" in order to draw conclusions about its utility for advancing the health of individuals and communities. The constituent domains of critical health literacy are identified; namely information appraisal, understanding the social determinants of health, and collective action, and as far as possible each are clearly delineated, with links to related concepts made explicit. The paper concludes that an appreciation of work undertaken in a range of different disciplines, such as media studies, medical sociology, and evidence-based medicine can enhance our understanding of the critical health literacy construct and help us understand its usefulness as a social asset which helps individuals towards a critical engagement with health information. There is some evidence that aspects of critical health literacy have indeed been found to be a resource for better health outcomes, but more research is needed in this area, both to develop quantitative and qualitative approaches to evaluating health literacy skills, and to offer convincing evidence that investment in programmes designed to enhance critical health literacy are worthwhile.
SourceAvailable from: Patrice Van Cleemput02/2015; 3(3):1-192. DOI:10.3310/phr03030
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ABSTRACT: Knowledge mobilization projects attempt to make theory and research available in order to inform policy and practice. This paper describes a knowledge mobilization project at a Canadian university. A database of Canadian health curriculum policies was analyzed to discern the general approaches to body image across the country. The findings show that learning how to cultivate a positive body image is inconsistently addressed across the education policies of the thirteen provinces and territories. Secondly, many Canadian curriculum policy documents have missed opportunities to teach acceptance of diverse body types and other protective factors. Third, health is more strongly associated with fitness in policies than with more holistic approaches. A knowledge mobilization website project was established to encourage more critical understandings of healthy self-esteem and body image. The website contains summaries of current research pertaining to body image, child and adolescent development, and key messages about body-positive health. The online and open source material available includes age-appropriate lessons for teachers and parents. These materials have been designed to translate research into activities, lessons, and key messages that promote healthy body image and self-esteem.
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ABSTRACT: While health literacy has been widely considered key to patient empowerment, an alternative approach separates both concepts and distinguishes between dif-ferent types of patients according to their levels of health literacy and empowerment. These types are deemed to vary in their health-related actions and outcomes. In this study, we exam-ine the relationship between health literacy and patient empowerment and compare socio-demographic characteristics, health-related activities, and health outcomes in four types of pa-tients suffering from chronic low back pain (cLBP). In a cross-sectional study, 273 cLBP patients from four Swiss can-tons (Vaud, Geneva, Fribourg, Ticino) and Lombardy (Italy) were invited by their healthcare providers to complete a self-administered paper-and-pencil questionnaire which assessed pa-tients' health literacy, empowerment, involvement in the medical encounter, medication non-adherence, and perceived pain and functionality as a measure of health outcomes. Health literacy and patient empowerment were not significantly correlated with each other, r(271) = .09, p > .05, allowing to differentiate be-tween four types of patients based on their levels of health literacy and patient empowerment. Subsequent chi-square tests and analyses of variances revealed significant differences among patients that could, however, only be attributed to health literacy, as in the case of age and ed-ucational attainment, or patient empowerment, as in the case of patients' involvement in the medical encounter. No significant differences were evident for gender, medication non-adherence, and health outcomes. The study provides empirical evidence for the need to consider health literacy and patient empowerment as independent concepts in the context of cLBP but calls for further studies to be able to conclude on how the two concepts interact and determine health-related activities and outcomes.PLoS ONE 02/2015; 10(2):e0118032. DOI:10.1371/journal.pone.0118032 · 3.53 Impact Factor