JMIR Publications

ABSTRACT

Background:

Children and adolescents extensively utilize the internet in their daily lives, often seeking information pertaining to health and well-being. In modern society, the amount of health information in digital environments is constantly increasing. This includes both reliable and misleading information, making it difficult to appraise their trustworthiness. Digital health literacy is key to navigate the digital information ecosystem, protect oneself from misleading information, and make appropriate health decisions.

Objective:

This representative study aimed to investigate digital health literacy of children and adolescents in Germany and its association with sociodemographic factors.

Methods:

A cross-sectional study design with face-to-face interviews was employed to collect data from N=1,448 children and adolescents from October to November 2022 in Germany. An adapted and translated version of the Digital Health Literacy Instrument (DHLI) with seven subscales was used to assess digital health literacy. Bivariate analysis and binary logistic regressions were performed to examine associations among digital health literacy dimensions and sociodemographic characteristics (sex, age, migration background, school type, perceived family affluence).

Results:

The study revealed a problematic level of digital health literacy for 30.8% of children and adolescents, while 4.6% had an inadequate level. On average the least difficulties were identified for operational skills, while the greatest difficulties were observed in relation to protecting privacy and navigation skills. Associations were found for age in six of seven subscales with an increased risk for limited skills in younger age (9 to 11 years) (OR=3.82 to 5.42, P<.01). Migration background and low perceived family affluence were associated with limited digital health literacy skills. In the subscales information searching, self-generated content and evaluating information reliability, a decreased risk for limited skills was found among those with a two-sided migration background (OR=0.30 to 0.66, P<.01) and an increased risk among those with low perceived family affluence (OR=1.58 to 2.18, P<0.1).

Conclusions:

The results suggest a high intervention need to enhance child and adolescent digital health literacy, particularly regarding protecting privacy, navigation skills, and evaluating the reliability of health information. Interventions that consider different needs concerning children and adolescents’ age, migration background and family affluence are required.