London South Bank University, London, UK.
Glob Health Promot. 2018 Dec;25(4):48-56. doi: 10.1177/1757975918789352. Epub 2018 Nov 14.
Critical health literacy is the least explored domain of health literacy and is addressed by few projects seeking to build health literacy. Lack of research means there is little evidence upon which to design effective interventions. Yet critical health literacy offers potential for individuals and communities to make important contributions to their own and society's health. This paper reports on an evaluation of a community project designed to develop critical health literacy.
The evaluation explored, (a) processes used to build critical health literacy and (b) the impact on the critical health literacy of participants. A mixed methods approach was used combining a pre-and post-intervention assessment of 14 of the 24 participants using the All Aspects of Health Literacy Scale, with participant focus groups and facilitator interviews.
Strategies used to build critical health literacy included informal and participatory learning, supported and independent assessment of the problem, appraising information, familiarisation of health systems and services, and social support. Common to these was learning within the context of participants' lives. Fewer strategies encouraged empowerment and political action. The evaluation showed slight improvements in some critical health literacy competencies: the ability to critically appraise health information and apply it to the context of their own lives and being able to critically question health professionals based on an individual's own research. However, there was no change in participants' ability to understand the determinants of health or involvement in activities for social and political change.
Informal, participatory community projects can successfully build many characteristics of critical health literacy. However, the political action element of critical health literacy remains the least well understood and faces particular challenges in its implementation.
批判性健康素养是健康素养中研究最少的领域，很少有项目试图培养健康素养。缺乏研究意味着在设计有效的干预措施方面几乎没有证据。然而，批判性健康素养为个人和社区为自己和社会的健康做出重要贡献提供了潜力。本文报告了对一个旨在培养批判性健康素养的社区项目的评估。
该评估探讨了（a）用于培养批判性健康素养的过程，以及（b）对参与者批判性健康素养的影响。采用混合方法，使用全健康素养量表对 24 名参与者中的 14 名进行了干预前后的评估，同时进行了参与者焦点小组和主持人访谈。
用于培养批判性健康素养的策略包括非正式和参与式学习、支持和独立评估问题、评估信息、熟悉健康系统和服务以及社会支持。这些策略的共同点是在参与者的生活背景下学习。较少的策略鼓励赋权和政治行动。评估显示，一些批判性健康素养能力略有提高：批判性地评估健康信息并将其应用于自己生活背景的能力，以及根据个人自己的研究对健康专业人员提出质疑的能力。然而，参与者理解健康决定因素的能力或参与社会和政治变革活动的能力没有变化。
非正式的、参与式的社区项目可以成功地培养批判性健康素养的许多特征。然而，批判性健康素养的政治行动要素仍然是理解最少的，在实施过程中面临着特殊的挑战。
