A Critical Health Literacy Podcast to Counter Health Misinformation at Scale: Randomized Controlled Trial

Widespread misinformation and low critical health literacy pose major barriers to public health worldwide. Rapid, scalable, and evidence-informed digital interventions are urgently needed to strengthen the public's ability to make informed health decisions.

Informed by critical health literacy frameworks, we developed and tested a brief, story-based critical thinking podcast, Parents Making Informed Health Choices, that was designed to improve critical health literacy and decision-making among US parents.

We conducted a 2-phase study. First, 5 parents participated in the user testing of the prototype podcast and provided qualitative feedback to refine content and delivery. The final podcast delivered 9 evidence-based practice principles through relatable scenarios about mental and physical health. In the second phase, we conducted a 2-arm randomized controlled trial (N=250) with a national online sample of US parents. Participants were randomly assigned to listen to either the critical thinking podcast (n=128, 51.2%) or a control podcast (n=122, 48.8%). There were no significant preintervention group differences except for age, which was controlled for in all analyses. Primary outcomes included critical thinking about health claims, intended health behaviors, attitudes toward evidence-based mental health practices, and treatment preferences.

On average, parents were aged 35 (SD 7.8) years; 49% (121/247) were female, 75% (185/248) were White; and 60.0% (148/248) had a bachelor's degree or higher. Parents who listened to the critical thinking podcast demonstrated significantly improved critical thinking about health information compared to the control group (B=2.56; P<.001; ∆R2=0.06). They also reported stronger critical thinking-aligned intended behaviors (B=0.252; P=.001; ∆R2=0.015), and more evidence-informed treatment preferences (B=4.89; P=.038; ∆R2=0.02). The effect sizes were small to moderate across outcomes.

Findings suggest that a brief, story-based digital podcast can meaningfully improve critical thinking about health information, intended behaviors, and evidence-based practice attitudes. Podcasts represent a promising, low-cost, and scalable strategy for promoting critical health literacy and countering health misinformation in the general public.