Critical Health Literacy: A Review and Critical Analysis

Florence Nightingale School of Nursing and Midwifery, King's College London, 57 Waterloo Road, London SE1 8AW, UK.
Social Science [?] Medicine (Impact Factor: 2.89). 05/2011; 73(1):60-7. DOI: 10.1016/j.socscimed.2011.04.004
Source: PubMed


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.

32 Reads
  • Source
    • "On the other hand health lifestyle information deals with issues or topics related to promoting or managing specific health or chronic conditions, preventing disease, and less frequently associated with treating specific ailments [19] [20]. While findings suggest that consumers' health literacy skills influence their ability to find and evaluate health information from different sources [5] [21] [22], it is less clear if this relationship varied by specific type of health information sought and the types of information sources used in the process [17] [23]. In this study we take both these factors into consideration and formulate our research goals accordingly. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The aim of this study is to investigate the relationship between five domain-specific skills of health literacy: Find Health Information (FHI), Appraise Health Information (AHI), Understand Health Information to act (UHI), Actively Manage One's Health (AMH), and E-health literacy (e-Heals), and health information seeking behaviors and three categories of health outcomes. Methods: A survey was implemented and data was collected from 1062 college going adults and analyzed using bivariate tests and multiple regression analysis. Results: Among the five domain-specific Health Literacy skills, AHI and e-Heals were significantly associated with the use of traditional sources and the Internet for healthcare information respectively. Similarly and AMH and e-Heals were significantly associated with the use of traditional sources and the Internet for health lifestyle information respectively. Lastly AHI, AMH and e-Heals were significantly associated with the three categories of outcomes, and AFH was significantly associated with cognitive and instrumental outcomes, but not doctor-patient communication outcomes. Conclusion: Consumers' ability to use different health sources for both healthcare and health lifestyle information, and the three categories of health outcomes are associated with different domain-specific health literacy skills. Practice implications: Health literacy initiatives may be improved by focusing on clients to develop domain-specific skills that increase the likelihood of using health information sources and accrue benefits.
    Full-text · Article · Dec 2015 · Patient Education and Counseling
  • Source
    • ", 2008 ) , we expect laypeople to be affected by this effect . In scientific contexts laypeople have low abilities for critical appraisal ( Chinn , 2011 ) . This means that laypeople with a high level of general self - efficacy would be less able to recognize the tentativeness of scientific research findings appropriately , while at the same time would overrate their scientific credibility . "
    [Show abstract] [Hide abstract]
    ABSTRACT: We examined in two empirical studies how situational and personal aspects of uncertainty influence laypeople’s understanding of the uncertainty of scientific information, with focus on the detection of tentativeness and perception of scientific credibility. In the first study (N = 48), we investigated the impact of a perceived conflict due to contradicting information as a situational, text-inherent aspect of uncertainty. The aim of the second study (N = 61) was to explore the role of general self-efficacy as an intra-personal uncertainty factor. In Study 1, participants read one of two versions of an introductory text in a between-group design. This text provided them with an overview about the neurosurgical procedure of deep brain stimulation (DBS). The text expressed a positive attitude toward DBS in one experimental condition or focused on the negative aspects of this method in the other condition. Then participants in both conditions read the same text that dealt with a study about DBS as experimental treatment in a small sample of patients with major depression. Perceived conflict between the two texts was found to increase the perception of tentativeness and to decrease the perception of scientific credibility, implicating that text-inherent aspects have significant effects on critical appraisal. The results of Study 2 demonstrated that participants with higher general self-efficacy detected the tentativeness to a lesser degree and assumed a higher level of scientific credibility, indicating a more naïve understanding of scientific information. This appears to be contradictory to large parts of previous findings that showed positive effects of high self-efficacy on learning. Both studies showed that perceived tentativeness and perceived scientific credibility of medical information contradicted each other. We conclude that there is a need for supporting laypeople in understanding the uncertainty of scientific information and that scientific writers should consider how to present scientific results when compiling pertinent texts.
    Full-text · Article · Nov 2015 · Frontiers in Psychology
  • Source
    • "Evidence has shown that health literacy intervention can have positive effect on health, particularly when combined with each other; further research indicated that health literacy skills declined with age. This is a fact that health literacy intervention is directed at relatively advanced students and requires a considerable investment of formal educational resources (Chinn, 2011). Researcher summarized that doctor, nurse, dentist, pharmacist, or public health workers also need health literacy skills in order to help people to better understand health information and services (King, 2010) . "
    [Show abstract] [Hide abstract]
    ABSTRACT: Health literacy is one of the most critical issues threating the public health today and there are significant gaps behind the discipline of health literacy. Low health literacy was found to threaten the health and welfare of people. The past decades witnessed a revolutionary alteration in the health patterns and disease spread among the community from infectious diseases to chronic diseases such as, heart disease, stroke, cancer, diabetes and accidents. Furthermore, to enhance health status among the population with effective intervention methods, through health teaching, increasing access to health information and communication technologies will eliminate the health literacy consequences among different community levels, including children and adults. The aim of the present review was to find out the current status about research progress towards health literacy. Furthermore, to examine health literacy status, intervention, possible consequences and future prospective, and to find out the options for improving health literacy status and fill in the future research. A systematic review based on literature research related to health literacy covered the recent publication from 2000 to 2014 years. The results indicated that the wide range opportunities for improving health literacy are coming through health literacy intervention among target community. Future research concerning health literacy is still needed to give much more efforts in the field of community and community health works.
    Full-text · Article · Apr 2015
Show more