Digital health literacy of pupils. Level and associations with physical activity and dietary behavior

Abstract

Background: While there are increasing empirical findings on general health literacy (HL), there is a lack of evidence on digital HL in adolescence and its association with health behavior. Methods: A cross-sectional study of 490 students from grade eight and nine from the federal state of Hesse was conducted from October 2019 to February 2020. Digital HL was assessed using five subscales of the Digital Health Literacy Instrument (DHLI), while consumption of fruits, vegetables, and soft drinks as well as weekly physical activity were used as indicators of health behavior. In addition to gender and grade level, subjective social status (SSS) was used as a social characteristic. Univariate, bivariate, and multivariate analyses were performed, with binary-logistic regression adjusted for gender and SSS. Results: Across all items, 15.3 to 37.5% of adolescents reported difficulties in acquiring and dealing with digital health information. Stratified by social characteristics, gender and socioeconomic differences were found with girls and respondents reporting a lower SSS more often showed a limited digital HL. Adolescents with moderate and low digital HL reported higher levels of low physical activity and non-daily fruit and daily soft drink consumption. Discussion: The findings suggest a need for interventions to promote digital HL among adolescents, particularly for those of low SSS. In this context, the differential relationship patterns with health behaviors provide an avenue for the development of specific interventions. The school as a place of teaching and learning is a suitable setting because, among other things, of its fit with the mandatory strategy of media literacy education in schools.