Abstract
BackgroundThe ability to critically appraise health information–often referred to as critical health literacy–is recognized as a crucial component of health literacy. Yet to date, it is not clear what specific abilities are needed to adequately accomplish this task, thereby hindering both its assessment and the development and evaluation of related interventions. By systematically building on past research, this study aimed to operationally define the concept of health information appraisal competence.MethodsWe systematically searched five scholarly databases to identify the conceptualizations and operational definitions of information appraisal in different disciplines. The resulting operationalization was subsequently validated through an online consultation exercise among 85 Swiss stakeholders.ResultsNinety-four publications were included in the review to the point of saturation. We extracted 646 skills, attitudes, and knowledge for health information appraisal. We then collated overlapping or duplicate statements, which produced a list of 43 unique statements belonging to six emergent themes or core competences: (1) basic competence, (2) predisposition, (3) identification competence, (4) critical evaluation competence, (5) selection competence, and (6) application competence. The consultation exercise enriched the operationalization of some of the core competences and confirmed the importance of all competences. Most skills, attitudes, and knowledge, however, were assigned low feasibility by the stakeholders.ConclusionsThis study was the first attempt to systematically operationalize health information appraisal competence. From a theoretical perspective, it sheds light on an understudied, health literacy domain, thus contributing to clarity around the concept. From a practical perspective, it provides a strong theoretical basis for the development of a tool to measure health information appraisal competence. This could be used routinely as a screening tool, as an outcome measure for public health interventions, or to identify citizens who are most at risk. Furthermore, it will provide support for the development of future interventions to build health information appraisal competence in the population.
Highlights
Due to its proven potential in mitigating several adverse health outcomes, such as lower usage of screening programs, less satisfaction with use of health services, lower adherence to medical regimens, or higher rates of hospitalization [1], health literacy (HL) is recognized as one of the main determinants of population health
As such, enhancing HL is increasingly being included in health promotion strategies worldwide
Our understanding of the concept of HL has undergone several important changes over the past decades. When it was first introduced in the field of health education more than 40 years ago, the term merely referred to a set of technical basic skills applied to the health context [3]
Summary
Due to its proven potential in mitigating several adverse health outcomes, such as lower usage of screening programs, less satisfaction with use of health services, lower adherence to medical regimens, or higher rates of hospitalization [1], health literacy (HL) is recognized as one of the main determinants of population health. Mainly ascribed to a growing interest in the topic among scholars from different disciplines, the concept has evolved to better reflect the complexity of a changing health information environment It encompasses several different competences, ranging from basic functional literacy skills, such as the ability to read and write, to more complex ones, such as the ability to navigate the healthcare system or, more recently, the ability to appraise health information. The ability to critically appraise health information–often referred to as critical health literacy–is recognized as a crucial component of health literacy To date, it is not clear what specific abilities are needed to adequately accomplish this task, thereby hindering both its assessment and the development and evaluation of related interventions. By systematically building on past research, this study aimed to operationally define the concept of health information appraisal competence
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