Interventions to promote critical health literacy: a scoping review

Critical health literacy (CHL) is regarded essential for critically appraising health information and making informed decisions. However, evidence on CHL-promoting interventions is low, leaving unclear how such interventions are implemented and evaluated, and which conceptualizations of CHL they draw on. This scoping review systematically identified and characterized CHL interventions, including target populations and settings, theoretical and methodological underpinnings, CHL dimensions addressed, evaluation approaches and reported implementation barriers and facilitators. We searched MEDLINE, CINAHL, APA PsycInfo, PSYNDEXplus and ERIC to September 2025 and supplemented this with backward citation searching. Publications reporting interventions with a stated or implicit CHL focus were included and synthesized narratively. Database searches yielded 3715 records and citation searching identified 117 additional records. After screening, 81 publications describing 53 distinct interventions were included. Publication activity increased from 2016 onwards, peaking between 2021 and 2025. Interventions were conducted in 19 countries and were concentrated in educational settings, mostly targeting school and university students. Most interventions focused on appraisal skills and individual action (e.g. informed decision-making), while broader CHL dimensions such as understanding social determinants of health and collective action were rarely addressed. Barriers included limited time and resources, technical infrastructure constraints and high demands on teachers, while facilitators included leadership support, training or coaching and high-quality learning materials. To strengthen CHL's preventive potential in health promotion, future interventions should prioritize large-scale effectiveness and follow-up studies, while accounting for context-sensitive adaptation, implementation conditions and broader operationalizations of all CHL dimensions across settings.