Mapping the Landscape of Critical Health Literacy: A Comprehensive Scoping Review of Research Trends and Associations with Health Behaviors

Abstract Critical health literacy (“CHL”) is concerned the complex skills needed for critical evaluation of health information. It holds potential to enhance beneficial practices such as adherence to public health policies and general health behaviors. However, no previous study has given a comprehensive overview of existing research on CHL and its association with health behaviors. This scoping review addresses this gap by reviewing 167 articles on CHL identified through a comprehensive search strategy encompassing 11 databases. We observed significant growth in CHL research post 2019, with a high number of conceptual papers and instrument validations. Consistent with previous critiques, we also identified potential conceptual conflation. Notably, of the 167 articles, only 28 explicitly reported associations between CHL and health behaviors, most of which concerned patient populations. Among these 28 studies, the majority identified significant associations between CHL and various health behaviors, while others reported mixed results. Importantly, some indicated that CHL was associated with reduced health behaviors. This scoping review concludes that the current research landscape of CHL is broad and heterogeneous. It underscores the need for further investigation into the complex association between CHL and different health behaviors to better understand its potential in health communication and policy development.