A054: Exploring Physical Education Teachers' Critical Health Literacy Structure and Assessment Tool Development

Under China's “Healthy China 2030” strategy and ongoing reforms in school physical education (PE), strengthening PE teachers' critical health literacy (CHL)—their ability to critically evaluate health information, make evidence-based decisions, and promote community health—has become essential. Although CHL holds both theoretical and practical significance, its structural dimensions among PE teachers remain insufficiently studied. This study systematically analyzes the theoretical framework of CHL and develops a validated assessment tool adapted to China's educational context. Method: A mixed-methods approach was adopted. First, over 200 CHL-related articles from CNKI, ProQuest, and other databases were analyzed to construct a preliminary framework. Second, 40 PE teachers, representing K-12, tertiary, and pre-service cohorts, participated in semi-structured interviews, including 14 individual and 26 group sessions. Transcripts were analyzed using grounded theory in NVivo14. Through open coding, 55 initial concepts (e.g., “health information evaluation”) were identified. These were then grouped into three core dimensions—health information management, decision-making execution, and health consciousness cultivation—via axial coding and ultimately refined into a three-dimensional model through selective coding. Third, a 27-item scale was iteratively developed. A pilot survey involving 100 teachers initially screened 46 items using CVR (CR > 0.4). The scale was further refined via exploratory factor analysis (EFA) (n=250), identifying three factors that explained 79.46% of the variance (α=0.973), and subsequently validated through confirmatory factor analysis (CFA) (n=304, χ ² /df=2.334, RMSEA=0.066). The CHL model consist of three dimensions: (1) Health Information Mastery (8 items, focusing on acquiring and evaluating health data), (2) Health Decision Execution (11 items, covering need identification, intervention design, and pedagogical optimization), and (3) Health Consciousness Cultivation (8 items, including role modeling, behavioral guidance, and collaborative advocacy). The finalized 27-item scale exhibited strong psychometric properties, including high internal consistency (α=0.973) and satisfactory model fit indices. This study advances CHL theory by incorporating both pedagogical and professional development dimensions, distinguishing it from previous frameworks that primarily emphasize individual health literacy. The validated tool addresses the lack of standardized PE teacher assessments, allowing for continuous monitoring of CHL development. This study's limitations include regional sampling bias and the use of cross-sectional data. Future research should enhance geographic diversity and adopt longitudinal designs to assess CHL’s influence on curriculum outcomes. In practice, the scale facilitates policy-driven teacher training and ensures quality assurance in health education, aligning with China’s modernization agenda.