Television and older adults’ navigational health literacy: A qualitative study of media representations and Audience Reception

Low health literacy, associated with poorer outcomes and higher costs for health systems and users, disproportionately affects older adults. In Portugal, 80.6% of individuals aged 65+ have insufficient health literacy. This qualitative study employed a sequential triangulation design to examine television’s role in mediating older adults’ navigational health literacy (HL-NAV). We purposively sampled 112 episodes across seven programmes on four national channels over 13 weeks and conducted focus groups with 22 older adults following curated TV screenings. Data were analysed using content and discourse analysis separately, then comparatively integrated across domains, guided by the HLS19-NAV framework. Findings reveal that televised health narratives are fragmented, biased, and predominantly promote individual responsibility and self-care, offering limited support for navigating the health system. These representations intersect with older adults’ accounts, highlighting gaps and barriers to HL-NAV. Results underscore the need to integrate TV into national health literacy strategies and develop targeted media interventions.