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A new framework integrates health literacy and competence for planetary and environmental health educationPlanetary Health Literacy Framework Proposed for Health Professionals

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Key Takeaway
Note that the PROF-PHL framework is a conceptual synthesis and requires empirical validation before clinical use.

This scoping review synthesizes existing literature to identify and define health literacy and competence concepts specifically within the context of planetary, climate, and environmental health. The authors synthesized 17 distinct concepts derived from 28 existing studies to inform the development of a professional planetary health literacy (PROF-PHL) framework.

The resulting PROF-PHL framework is structured around four core dimensions: access, understand, appraise, and apply. These dimensions are intended to embed essential competencies into the professional training of health professionals to better address environmental health issues.

A primary limitation noted by the authors is that the PROF-PHL framework is currently a conceptual synthesis and has not undergone empirical validation. Clinical application of the framework for professional training is currently limited by this lack of empirical data.

For healthcare educators and administrators, the framework may serve as a conceptual tool for integrating environmental health competencies into professional training programs. However, its practical utility remains preliminary until empirical validation is conducted.

A new scoping review looked at how health literacy and competence are described when it comes to planetary, climate, and environmental health. The authors combined ideas from 28 existing studies and identified 17 health literacy and competence concepts. The review did not involve patients or test any program, and no sample size or setting was reported.

From these concepts, the authors built a framework they call professional planetary health literacy, or PROF-PHL. It organizes core competences across four dimensions: access, understand, appraise, and apply. The idea is that health professionals would be able to find, grasp, judge, and use environment-related health information.

The authors say the framework could help training programs for health professionals include environment-related health competences. No safety concerns were reported, but none were looked for, since this was not a treatment study.

The main reason to be careful is that the framework is a conceptual synthesis. It has not been tested in real training programs or with real health workers, so the authors say it still needs empirical validation. For now, this is an early organizing idea, not proof that it improves practice or health outcomes.

What this means for you:
A new framework organizes climate and environmental health skills for professionals, but it still needs real-world testing.

Common questions

What is the PROF-PHL framework?

PROF-PHL stands for professional planetary health literacy. It is a framework built from 17 health literacy and competence concepts found across 28 existing studies. It groups core competences into four dimensions: access, understand, appraise, and apply. The authors suggest it could help shape training for health professionals on environment-related health topics.

Has this framework been tested?

No. The authors describe it as a conceptual synthesis, meaning it was built by combining ideas from existing studies rather than by testing a program. They state that the framework requires empirical validation. So it is an early organizing idea, not evidence that it changes training or health outcomes.

Who might this framework be for?

The review focuses on health professionals and their training. The authors say the framework could support integrating environment-related health competences into professional training programs. It was not designed or tested for patients or the general public, and the review did not report a sample size or setting.

Were any safety concerns reported?

No adverse events or safety issues were reported. However, this was not a treatment study, so safety was not measured or looked for. The review did not test an intervention in people, so questions about side effects or risks do not directly apply to this work.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
IntroductionThe health literacy of health professionals regarding planetary, climate, and environmental issues is crucial for protecting, promoting, and preserving human and planetary health, especially in the face of increasing environmental risks. To date, no systematic review of the existing literature has been conducted. This scoping review aimed to cluster and analyze scientific evidence on health literacy and competence concepts in the context of planetary, climate, and environmental health as applied to health professionals. Based on these findings, the aim was to develop a new, comprehensive, evidence-informed educational framework to promote professional planetary health literacy (PROF-PHL), to support the professional literacy development in addressing the growing challenges of planetary health.MethodsThe scoping review was conducted in accordance with the JBI and PRISMA-ScR guidelines. Systematic searches were conducted in MEDLINE, CINAHL, and Web of Science, supplemented by manual searches. The results were evaluated using a combination of descriptive and deductive-inductive content analysis, in line with Kuckartz’s typification approach.ResultsThe review synthesized 17 health literacy and competence concepts from 28 existing studies on planetary, climate and environmental health. The review examined the concepts’ definitions, theoretical foundations, and environmental-health nexus, as well as their determinants across eight domains: knowledge, competences, attributes, competence dimensions, objectives, context, development processes, and proximal and distal antecedents. These were then integrated into an evidence-informed PROF-PHL framework through a conceptual synthesis. This framework embeds core competences across four dimensions—access, understand, appraise, and apply. The framework highlights the critical roles of systemic conditions, interprofessional education, and transformative action in advancing PROF-PHL.DiscussionThe field of environment-related health literacy is characterized by conceptual heterogeneity and overlap, with a focus on individual competences. There has been a shift from one-sided environment-to-health concepts towards systemic, bidirectional approaches. Based on the available evidence, we have developed an integrative PROF-PHL framework that combines core competences, systemic determinants, and transformative action. This framework could support the integration of environment-related health competences into professional training programs, providing a foundation for initiatives that empower health professionals to promote planetary health in clinical, social, and political contexts. As a conceptual synthesis, however, the framework requires empirical validation.Systematic review registrationhttps://doi.org/10.17605/OSF.IO/HYNJR
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