Evidence mapPaperPMID 41459201Full record

ArticleCritical public health2025

Development and Validation of a Critical Health Literacy Scale: Exploring Media Literacy, Social Determinants, and Empowerment.

Mi Zhou, A Susana Ramírez, Sandie Ha, Deepti Chittamuru, Yueqi Yan

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Article in Critical public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Mi ZhouDepartment of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, USA.ORCID 0000-0001-8822-4188
A Susana RamírezSchool of Social Sciences, Humanities, and Arts, University of California, Merced, USA, 5200 North Lake Road, Merced, CA 95343.ORCID 0000-0002-9095-5358
Sandie HaDepartment of Public Health, University of California, Merced, USA.
Deepti ChittamuruDepartment of Public Health, University of California, Merced, USA.
Yueqi YanBiostatistics and Data Support Center, University of California, Merced, USA.

Funding

Translational Research Core - Health Engagement & Action Translational (HEAT)P30DK092924 · KAISER FOUNDATION RESEARCH INSTITUTE · 2025 to 2025
$700k
NCI NIH HHS K01 CA190659NIDDK NIH HHS P30 DK092924
6 · The paper itself

Abstract

Introduction: Critical health literacy has attracted much attention as an indicator of success beyond individual behavior change objectives in health promotion and as a tool to assess public health education. Despite its importance, there remains no consensus about how to operationalize critical health literacy. Building on Freire's concepts of critical consciousness and empowerment, we conceptualize critical health literacy as comprising reflection (media literacy and awareness of social determinants) and action (psychological empowerment). Methods: We developed and validated an 18-item critical health literacy scale among young adult Latinas (N=1,029) aged 18-29 years (mean age=19.6). The scale measures three dimensions: media literacy, awareness of social determinants of health, and psychological empowerment. Face and content validity were established through focus groups and expert panel reviews. We used exploratory factor analysis (EFA) on half the sample to identify the dimensional structure, followed by confirmatory factor analysis (CFA) on the remaining half to assess convergent and discriminant validity. Results: The EFA and CFA confirmed a five-factor structure with acceptable fit indices (TLI=.96, CFI=.95, RMSEA=.04, SRMR=.03). The scale demonstrated high internal consistency and composite reliability. Convergent and discriminant validity were established for most subscales, with the community control subscale showing weaker but theoretically important psychometric properties. Discussion: The validated critical health literacy scale provides a reliable tool for assessing understanding of social and commercial determinants of health and the degree to which young people feel empowered to engage in social change. This instrument can evaluate health promotion interventions at multiple levels within a socio-ecological framework and advance research on factors influencing health inequities among populations experiencing health disparities.

Indexed as

commercial determinants of healthempowermentLatinasmeasurementpsychological empowermentracialized marketingsocial determinants of healthsocio-ecological modelyoung adults

Identifiers

PMID41459201
PMCPMC12742978

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.