Environmental health literacy competencies and teaching methods for students and health professionals in Primary Health Care: A scoping review.

Environmental determinants play an increasingly important role in shaping population health, highlighting Environmental Health Literacy (EHL) as a critical competency for Primary Health Care (PHC). Despite growing attention to environmental health education, evidence addressing EHL in PHC remains fragmented and inconsistently conceptualized. This scoping review aimed to systematically map existing evidence on environmental health literacy among health professions students and practicing professionals in PHC settings, with a focus on identifying core competency domains and educational interventions relevant to PHC practice. A scoping review was conducted in accordance with PRISMA-ScR guidelines. Searches were performed across seven electronic databases, complemented by additional searches in Google Scholar and grey literature sources. Empirical and theoretical studies examining EHL or closely related environmental health constructs in PHC or PHC-relevant contexts were included. Twenty-nine studies met the inclusion criteria, comprising 24 empirical studies and five theoretical contributions. This review represents the first synthesis explicitly framed within the EHL context for PHC. Across studies, five core EHL domains consistently emerged: environmental health knowledge, clinical skills, risk communication, equity-oriented attitudes, and systems-based advocacy. Building on this synthesis, the review proposes a consolidated set of global competencies for EHL in PHC and systematically maps educational and practice-based interventions aimed at developing these competencies, particularly multimodal and technology-enhanced approaches. While several interventions demonstrated improvements in knowledge, skills, and self-efficacy, evidence of sustained integration into routine PHC practice remained limited. Overall, the findings demonstrate that EHL is a multidimensional and foundational competency for PHC but is most often addressed implicitly rather than explicitly. Bridging the gap between education and clinical application will require sustained curricular integration, institutional support, and system-level alignment to ensure that PHC professionals are equipped to address environmental determinants of health in an increasingly complex global context.