BackgroundInterest in and debates around health literacy have grown over the last two decades and key to the discussions has been the distinction made between basic functional health literacy, communicative/interactive health literacy and critical health literacy. Of these, critical health literacy is the least well developed and differing interpretations of its constituents and relevance exist. The aim of this study is to rigorously analyse the concept of critical health literacy in order to offer some clarity of definition upon which appropriate theory, well grounded practice and potential measurement tools can be based.MethodThe study uses a theoretical and colloquial evolutionary concept analysis method to systematically identify the features associated with this concept. A unique characteristic of this method is that it practically combines an analysis of the literature with in depth interviews undertaken with practitioners and policy makers who have an interest in the field. The study also analyses how the concept is understood across the contexts of time, place, discipline and use by health professionals, policy makers and academics.ResultsFindings revealed a distinct set of characteristics of advanced personal skills, health knowledge, information skills, effective interaction between service providers and users, informed decision making and empowerment including political action as key features of critical health literacy. The potential consequences of critical health literacy identified are in improving health outcomes, creating more effective use of health services and reducing inequalities in health thus demonstrating the relevance of this concept to public health and health promotion.ConclusionsWhile critical health literacy is shown to be a unique concept, there remain significant contextual variations in understanding particularly between academics, practitioners and policy makers. Key attributes presented as part of this concept when it was first introduced in the literature, particularly those around empowerment, social and political action and the existence of the concept at both an individual and population level, have been lost in more recent representations. This has resulted in critical health literacy becoming restricted to a higher order cognitive individual skill rather than a driver for political and social change. The paper argues that in order to retain the uniqueness and usefulness of the concept in practice efforts should be made to avoid this dilution of meaning.

The research demonstrated how poorly integrated people with intellectual disabilities are within mainstream society. Desired characteristics and expectations for participant's relationships were rooted in a shared history and culture, which was shaped by their intellectual disability and support needs.

Accessible summary• Much research has taken place to understand love and what it means.• People with learning disabilities can have difficulties finding love for many reasons.• People with learning disabilities were interviewed, and they said that having a partner who loved them and who provided company and support was very important to them.• People enjoyed a physical relationship; this could be kissing, cuddling or having sex.• People who had been abused in some way said it felt good to have a partner who loves and supports them.• Good support from staff was important to help people to find love. A drawing was made to explain to staff how they can support people with relationships. AbstractBackground: Love is important aspect of life, including to people with learning disabilities both historically and more recently. Participants value the companionship, support and social status associated with a partner. Relationships are considered mechanisms to meet certain needs including feeling loved, company, intimacy and enabling individuals to marry and have children. This article examines the importance of romantic love to people with learning disabilities.Methods: A hermeneutic phenomenological study, guided by the theory of Van Manen was conducted using interviews with eleven people with learning disabilities examining the importance of romantic love.Results: The analysis revealed that love was important to them, specifically the companionship and support a loving partner provided. The physical expression of love by a partner was valued highly, especially kissing and cuddling. Most participants had experienced some form of abuse, but it appeared that the love of a partner was reparative and they were able to form satisfying relationships. Conclusion: Participants' narratives highlighted the role staff play in supporting them to fulfill their romantic needs. The romantic relationship needs of people with learning disabilities were examined in relation to Maslow's hierarchy of needs. The hierarchy was revised to reflect the value of having a lovingThe Official Journal of the British Institute of Learning Disabilities relationship to people with learning disabilities and to identify the support they required to facilitate and maintain this.

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