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      Key concepts for informed health choices: Where’s the evidence?

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          Abstract

          Background: The Informed Health Choices (IHC) Key Concepts is a framework that provides a basis for developing educational resources and evaluating people’s ability to think critically about health actions. We developed the original Key Concepts framework by reviewing texts and checklists for the public, journalists, and health professionals and collecting structured feedback from an international advisory group. We revised the original 2015 framework yearly from 2016 to 2018 based on feedback and experience using the framework. The objectives of this paper are to describe the development of the framework since 2018 and summarise their basis.

          Methods: For the 2019 version, we responded to feedback on the 2018 version. For the current 2022 version, in addition to responding to feedback on the 2019 version, we reviewed the evidence base for each of the concepts. Whenever possible, we referenced systematic reviews that provide a basis for a concept. We screened all Cochrane methodology reviews and searched Epistemonikos, PubMed, and Google Scholar for methodology reviews and meta-epidemiological studies.

          Results: The original framework included 32 concepts in six groups. The 2019 version and the current 2022 version include 49 concepts in the same three main groups that we have used since 2016. There are now 10 subgroups or higher-level concepts. For each concept, there is an explanation including one or more examples, the basis for the concept, and implications. Over 600 references are cited that support the concepts, and over half of the references are systematic reviews.

          Conclusions: There is a large body of evidence that supports the IHC key concepts and we have received few suggestions for changes since 2019.

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          Most cited references52

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          Critical health literacy: a review and critical analysis.

          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. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            How we think.

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              A comparative analysis of international frameworks for 21stcentury competences: Implications for national curriculum policies

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data CurationRole: Formal AnalysisRole: Funding AcquisitionRole: InvestigationRole: MethodologyRole: Project AdministrationRole: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Role: ConceptualizationRole: Formal AnalysisRole: Funding AcquisitionRole: InvestigationRole: MethodologyRole: Writing – Review & Editing
                Role: ConceptualizationRole: Data CurationRole: Formal AnalysisRole: InvestigationRole: MethodologyRole: Project AdministrationRole: Writing – Review & Editing
                Journal
                F1000Res
                F1000Res
                F1000Research
                F1000 Research Limited (London, UK )
                2046-1402
                4 August 2022
                2022
                : 11
                : 890
                Affiliations
                [1 ]Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
                [2 ]Centre for Evidence-Based Medicine, Department of Primary Care, University of Oxford, Oxford, UK
                [3 ]Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
                [1 ]Inclusive Education Unit, Institute of Professional Development in Education, University of Graz, Graz, Austria
                [2 ]Research Center for Inclusive Education (RCIE), Institute of Education Research and Teacher Education, University of Graz, Graz, Austria
                [1 ]Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
                [2 ]Department of Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
                [1 ]Interdisciplinary Center for Health Sciences, Institute of Health and Nursing Science, Martin Luther University, Halle, Germany
                Author notes

                No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Author information
                https://orcid.org/0000-0002-6377-3321
                Article
                10.12688/f1000research.123051.1
                10623542
                e6bccb19-3b09-4e26-a5a8-ad84bf8528db
                Copyright: © 2022 Oxman AD et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 July 2022
                Funding
                Funded by: Research Council of Norway
                Award ID: 220603/H10
                Funded by: Research Council of Norway
                Award ID: 284683
                This work was supported by the Research Council of Norway (Project numbers 220603/H10 and 284683). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Articles

                concepts,critical thinking,critical appraisal,causal inference,critical health literacy,treatment claims,informed decision making,epistemology; systematic review

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