Teaching methods for critical thinking in health education of children up to high school: A scoping review.

According to the World Health Organization, the improvement of people's health literacy is one of the fundamental public health challenges in the 21st century. The key issue in teaching health literacy is to develop critical thinking skills. As health literacy and critical thinking should be developed at school age, we reviewed teaching methods or educational interventions used in empirical studies focused on the development of critical thinking regarding health and implemented by teachers in preschools, primary schools, or secondary schools. We searched seven databases (Medline, Embase, Web of Science, ERIC, ProqQuest, PsycArticles, and CINAHL) from inception to 20 September 2023 for any type of empirical studies. Due to the heterogeneity in interventions and inadequate reporting of results, a descriptive synthesis of studies was performed in addition to quantitative analysis. Of the 15919 initial records, 115 studies were included in the review. Most of the educational interventions focused on lifestyle-related health issues such as substance use, sexual and reproductive health, and nutrition. The popularity of health issues changed over time and depended on the geographical context. Six dimensions that differentiated the teaching methods were identified: central teaching component, central educator, pupils' activity level, teaching context, educational materials, and significance of critical thinking. Many educational interventions did not address the development of critical thinking skills in a comprehensive manner, and the significance of critical thinking varied greatly. Interventions in which critical thinking had high and very high significance applied mainly problem-solving methods and involved pupils' activity. The evidence on the effectiveness of the teaching methods that develop critical thinking is limited because most articles failed to provide detailed information on the teaching methods or did not examine their effects. We recommend that a checklist is developed to facilitate a detailed description of health educational interventions and thus promoting their replicability. Study registration: The protocol of the review was registered in the OSF Registries on 13 January 2022 (doi: https://doi.org/10.17605/OSF.IO/46TEZ).

Agency in urgency and uncertainty. Vaccines and vaccination in European media discourses.

Although Covid-19 was not the first pandemic, it was unique in the scale and intensity with which societies responded. Countries reacted differently to the threat posed by the new virus. The public health crisis affected European societies in many ways. It also influenced the way the media portrayed vaccines and discussed factors related to vaccine hesitancy. Europeans differed in their risk perceptions, attitudes towards vaccines and vaccine uptake. In European countries, Covid-19-related discourses were at the centre of media attention for many months. This paper reports on a media analysis which revealed significant differences as well as some similarities in the media debates in different countries. The study focused on seven European countries and considered two dimensions of comparison: between the pre-Covid period and the beginning of the Covid pandemic period, and between countries. The rich methodological approach, including linguistics, semantic field analysis and discourse analysis of mainstream news media, allowed the authors to explore the set of meanings related to vaccination that might influence actors' agency. This approach led the authors to redefine vaccine hesitancy in terms of characteristics of the "society in the situation" rather than the psychological profile of individuals. We argue that vaccine hesitancy can be understood in terms of agency and temporality. This dilemma of choice that transforms the present into an irreversible past and must be taken in relation to an uncertain future, is particularly acute under the pressure of urgency and when someone's health is at stake. As such, it is linked to how vaccine meaning is co-produced within public discourses.

Trust matters: The Addressing Vaccine Hesitancy in Europe Study.

This article presents the design of a seven-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study consists of (a) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination and (b) participant observation and in-depth interviews of healthcare professionals and vaccine-hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among healthcare professionals involved in discussing childhood vaccines with parents. We present the selection of countries and regions, the conceptual basis of the study, details of the data collection and the process of designing and evaluating the interventions, as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and methods.

When Peppa Pig and Confucius meet, joining forces on the battlefield of health literacy-a qualitative analysis of COVID-19 educational materials for children and adolescents from China, the USA, and Europe.

In times of pandemic, health literacy (HL) is very important, as it helps to find, understand, and use essential health information and services. According to WHO, HL is pivotal in fighting infodemic effectively, and education is a vital tool for developing it. In the presented work, we analyze 247 educational materials dedicated to children, adolescents, and their carers explaining the pandemic, prepared by the Chinese, American, German, Italian and Polish governments and international non-governmental organizations. Focusing on the textual and visual side of the documents, we investigated how the pandemic is explained and what discursive measures were used to inform young citizens about the risks and consequences of pandemic restrictions. Additionally, we verified whether the materials helped developing critical thinking, which is crucial to prevent spreading fake news and conspiracy theories. Although the analyzed materials were prepared in different cultural contexts, we identified that all of them contained simple instructions on the desired behaviours during the pandemic. Key messages relating to the importance of hygienic behaviors were often supplemented with guidelines on how to successfully complete each action. While the cultural particularities in presenting the state of the pandemic are visible, the challenges of dealing with the emotional and social crises were dominant all around the world. In our study, we argue that the possibilities of building HL were not fully exploited by the national and international institutions. Citizens were taught how to behave in unusual circumstances but not why they should behave differently. The educational materials lacked reliable knowledge that would allow them to deal with infodemic and develop critical thinking. We conclude that health education expertise worldwide should be focused on enhancing individuals' ability to make informed health decisions and provide three recommendations regarding the process of development of health educational resources for children and the youth.

From community of practice to epistemic community - law, discipline and security in the battle for the legalisation of medical cannabis in Poland.

Although public debates on cannabis are ongoing in many countries, there are currently no EU-wide rules for either medical or recreational use of cannabis. Numerous studies have illustrated that creating such rules is a complex challenge. The battle over the legalisation of medical use of cannabis in Poland is a good example for analysing the mutual impact of the social practices that various actors perform through and by the discourses in the field of health care: how they discursively create their own roles and take positions and how they shape the coalitions and opposition in trying to achieve their strategic goals. This article aims to reconstruct and explain how different types of knowledge are discursively used to sustain or question power relations in the healthcare field. The dispersed knowledge-power influences social actors, who try to define or redefine social practices and aspire to guide them in the healthcare field. The presented approach allows authors to go beyond the social actors' perception vs institutional regulations and to analyse discursive actions as elements of the complex networks of meanings activating various type of resources. Those dynamic networks, involving the different (and sometimes the same) actors in the different actions, open the new fields of rationality. Starting by identifying the crucial actors and their discursive actions visible in the mainstream press discourse, we will reconstruct three types of groups related to medical cannabis. We will then investigate three types of dispositives - law, discipline and security - to investigate the relations between discursive and non-discursive elements. The proposed analysis belongs to the Critical Discourse Analysis (CDA) paradigm and includes investigation of the media discourses and in-depth interviews with the identified actors.

Much Ado about nothing? The responsiveness of the healthcare system in Poland through patients' eyes.

This article analyzes the outcomes of the key healthcare reforms undertaken in Poland and assesses how successful they have been. Contrary to the governmental perspective on success, understood in terms of economic efficiency, we define it in terms of patient satisfaction. As such, health policy is treated as a political system's response to the problems emerging in the public agenda. The analysis therefore focuses on the responsiveness of the healthcare system through patients' eyes. This analysis takes three main reforms undertaken in post-1989 Poland as reference points. These were: Regional Sickness Funds (Kasy Chorych, 1999); the National Health Fund (Narodowy Fundusz Zdrowia, 2003/2004); and the waiting lists package and the oncological package (pakiet kolejkowy and pakiet onkologiczny, 2015). Each introduced key institutional changes, but also sparked media interest, public attention, and mass discourse. The article presents the main goals and the most important consequences of the reforms for patients. For the purposes of the analysis, the following patient-oriented indicators of reform success were chosen: (1) public satisfaction with healthcare, (2) waiting times, (3) number of health professionals. The assembled data from national and international databases leads to the conclusion that the reforms have not succeeded.