Applying Critical Thinking Frameworks in Public Health: A Systematic Review of Strategic Approaches to Enhance Decision-Making and Policy Development.

Background and Aims: Critical thinking play a vital role in enhancing public health decision-making by enabling professionals to assess interventions, address complex challenges, and formulate effective policies. This systematic review aims to evaluate the application of structured critical thinking frameworks in public health, highlighting their effectiveness in improving evidence-based decision-making and policy development. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were searched for peer-reviewed studies published between 1990 and 2024. Studies were eligible if they focused on the application of critical thinking frameworks-specifically Socratic Questioning, Root Cause Analysis, Delphi Method, Scenario Planning, or the Paul-Elder Critical Thinking Framework-in public health contexts. Data extraction and quality assessment were performed independently by two reviewers using the CASP checklist. Results: Eighty-six studies were included. Five major frameworks were identified and synthesized: Socratic Questioning promotes analytical dialog and stakeholder engagement; the Paul-Elder Framework enhances structured reasoning and policy analysis; Scenario Planning supports long-term adaptive policy development; Root Cause Analysis identifies systemic failures and guides targeted interventions; and the Delphi Method fosters expert consensus in complex decision-making. These frameworks collectively support improved reasoning, inclusivity, and strategic planning in public health policy and practice. Conclusion: Structured critical thinking frameworks contribute significantly to strengthening public health decision-making and policy formulation. Their integration into public health systems and training programs can enhance policy adaptability, equity, and effectiveness. Future research should explore their long-term impact across diverse cultural and organizational contexts.