- 10.00-11.00: trial lecture.
- 12.15-15.30: public defence.
Title of the trial lecture: "Based on existing theory and prior research; propose an intervention-study that aims to develop health literacy and information management in the context of Physical Education. Theoretical and methodological considerations should be discussed."
The title of the thesis is "Measuring critical health literacy in lower secondary schools – exploring key aspects for health education in Norway".
The committee consist of
- first opponent, Professor Orkan Okan, Department of Sport and Health Sciences, Technical University of Munich
- second opponent, Professor Tommy Haugen, Department of Sports Science and Physical Education, University of Agder
- chair of the committee, Associate Professor Elisabeta Eriksen, Department of Primary and Secondary Teacher Education, OsloMet
The leader of the public defence is Finn Aarsæther, Vice-Dean of Education, Faculty of Education and International Studies, OsloMet.
The main supervisor is Professor Ove Edvard Hatlevik, OsloMet. The co-supervisors are Associate professor Marc Esser-Noethlichs, OsloMet and Professor Kirsti Riiser, OsloMet.
Summary
The introduction of Health and Life Skills (HLS) in the national curriculum sparked renewed discussions around health education in Norway. The interdisciplinary theme aims to nurture competencies that promote physical and mental health while enabling students to make responsible life choices.
In the discussions preceding the curricula reform, critical voices raised some concerns with implementing HLS in schools. One was related to the topic not being clearly described, which could lead to fragmented and inconsistent health education. Amidst these concerns, there was also a broader critique of the tendency to emphasize individual responsibility for health in education and society.
In this thesis, critical health literacy (CHL) is suggested for framing and understanding health education to meet these concerns. CHL is a type of health literacy (HL) that includes competencies in three domains (A-C). Domain A revolves around appraising the quality of health information. Domain B includes a deeper understanding of how health is developed and sustained in society. Domain C revolves around abilities that enable health-promoting actions in a collective.
This thesis aims to contribute to the discussion on HLS by laying the groundwork for developing knowledge about CHL among students in Norwegian lower secondary schools. It comprises two main objectives: firstly, to develop and test indicators of CHL encompassing three measurement domains, and secondly, to explore the critical pedagogical approach inspired by Paulo Freire as an approach to foster CHL competencies in schools.
The thesis consists of three Articles. The initial phase aimed to develop indicators to measure CHL and resulted in the Critical Health Literacy for Adolescents Questionnaire (CHLA-Q). The development process involved a comprehensive literature review, focus group interviews (N=15), and pilot testing of the survey (N=114), as reported in Article I.
Article I
The primary findings were key characteristics within each domain of CHL. Adolescents evaluate the credibility and relevance of health-related information using criteria such as accuracy, impartiality, and relevance. Furthermore, in discussions, young people can reflect on and understand complex social determinants of health. In domain C, self-efficacy in providing social support and participation in democratic discussions is highlighted. In the statistical analysis of the pilot survey, exploratory factor analysis was used to develop scales within each domain.
Article II
The psychometric properties of the CHLA-Q were examined through confirmatory factor analysis of data from a cross-sectional survey in five lower secondary schools (N =521). The overall fit of the CHLA-Q was acceptable; however, the results indicate that more work is needed to develop reliable and valid scales within domain B. The discussion highlighted the relevance of CHL in the school context and underscored the need for robust measurement tools to assess CHL among adolescents.
Article III
Two scales in domain C are applied to examine the association between CHL and academic achievement in Physical Education (PE). The results indicate a positive relationship. Furthermore, the association remains when controlling for participation in sports club activities, leisure physical activity, and parent’s education.
The second objective was to explore a pedagogical approach to nurture CHL in schools, specifically, a critical pedagogy inspired by Paulo Freire. In this part of the thesis, PE serves as an example to investigate how a critical pedagogical approach can contribute to fostering CHL among students. The potential of critical pedagogy to empower students, enhance student-teacher relationships, and mitigate healthism tendencies is emphasized.
Conclusion
This thesis contributes to the discourse surrounding health education in Norwegian schools by advancing the understanding of CHL. The development of the CHLA-Q provides a valuable tool for assessing CHL competency among adolescents. At the same time, exploring critical pedagogy offers insights into pedagogical approaches to fostering CHL. Integrating health education topics into teacher education programs is recommended, and enhancing interprofessional collaboration is one crucial aspect of this work.
