Operationalising Critical Health Literacy: Gambling Harm Education & Commercial Health Determinants
Abstract
Introduction: Critical health literacy (CHL) is commonly defined as the ability to critically reflect on the determinants of health and translate that reflection into individual or collective action. However, relatively few examples exist of what CHL looks like in practice within health education. This paper presents a commercial determinants-framed gambling harm education programme as a real-world example.
Methods: We describe the development of a UK gambling harm prevention programme created through a five-year academic–Lived Experience partnership. The educational approach combines lived experience narratives with clinician-led evidence and learning activities that develop multiple critical literacies, including commercial, media, digital, political and environmental literacy. Drawing on programme theory and qualitative evaluation findings, opportunities for critical reflection and action are illustrated.
Results: Critical reflection is fostered by encouraging young people to examine the commercial determinants of gambling harm, including product design, marketing, digital environments, political influence and narratives of individual responsibility. Reflection is linked to three forms of action. As consumers, young people can make more autonomous decisions. As carers, they develop confidence to recognise harm, reduce stigma and support others. As citizens, they engage in youth policy development, public health campaigns, and engagement with elected representatives.
Conclusions: This case study demonstrates how CHL can move beyond information provision towards educational approaches that develop critical understanding, agency, and participation. Gambling harm education provides a real-world example of how reflection and action can be integrated to support young people in understanding, navigating and influencing the commercial environments that shape health.
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BibTeX
@article{mills2026operationalising,
title = {{Operationalising Critical Health Literacy: Gambling Harm Education & Commercial Health Determinants}},
author = {T Mills and J Grimes},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.761},
url = {https://doi.org/10.1093/eurpub/ckag169.761},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Operationalising Critical Health Literacy: Gambling Harm Education & Commercial Health Determinants
AU - T Mills
AU - J Grimes
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.761
UR - https://doi.org/10.1093/eurpub/ckag169.761
AB - Introduction: Critical health literacy (CHL) is commonly defined as the ability to critically reflect on the determinants of health and translate that reflection into individual or collective action. However, relatively few examples exist of what CHL looks like in practice within health education. This paper presents a commercial determinants-framed gambling harm education programme as a real-world example. Methods: We describe the development of a UK gambling harm prevention programme created through a five-year academic–Lived Experience partnership. The educational approach combines lived experience narratives with clinician-led evidence and learning activities that develop multiple critical literacies, including commercial, media, digital, political and environmental literacy. Drawing on programme theory and qualitative evaluation findings, opportunities for critical reflection and action are illustrated. Results: Critical reflection is fostered by encouraging young people to examine the commercial determinants of gambling harm, including product design, marketing, digital environments, political influence and narratives of individual responsibility. Reflection is linked to three forms of action. As consumers, young people can make more autonomous decisions. As carers, they develop confidence to recognise harm, reduce stigma and support others. As citizens, they engage in youth policy development, public health campaigns, and engagement with elected representatives. Conclusions: This case study demonstrates how CHL can move beyond information provision towards educational approaches that develop critical understanding, agency, and participation. Gambling harm education provides a real-world example of how reflection and action can be integrated to support young people in understanding, navigating and influencing the commercial environments that shape health.
SN - 1101-1262
SN - 1464-360X
ER -