Co-designing an education resource to enhance adolescents’ digital health literacy

Abstract

Background: Dynamic adolescence growth phase involves progressive autonomy in health. Adolescents integrate digital technologies throughout their lives, including health, which requires digital health literacy (DHL) to identify trustworthy, relevant sources. Those with poor DHL risk using misinformation; many want to improve their DHL but education is limited . We explored adolescents’ DHL and education needs, co-designed an education resource and evaluated it.   Methods: A three-phase mixed-method study: 1)adolescents (12-17 years) completed the eHEALS self-report DHL measure , and search/appraisal task and semi-structured interview to compare perceived and actual DHL; 2)with another sample across four workshops, we co-designed an education resource to improve DHL; 3)with another sample, we evaluated the resource using eHEALS and a search/appraisal task before and after using the resource.   Results: 21 participants had reasonable self-efficacy using online health information but perceived DHL was higher than that demonstrated. They accessed health information intentionally via Google and unintentionally on social media; most appraised it using general heuristics taught at school, many insufficiently nuanced, sometimes resulting in misplaced trust or reduced self-efficacy. During co-design with 21 participants, education design solutions favoured a video-based resource for mobile devices, with branching storylines and interactive quizzes.Evaluation of the resource with 30 participants resulted in increased DHL self-assessment (26.6/40-30.6/40,p<0.001); more participants sought sources indicating trustworthiness on government and official health websites throughout Google results; 26/30 improved DHL.   Conclusions: Adolescents have many DHL skills and generally feel self-efficacious but need enhanced critical health literacy. Co-design ensured the education resource was engaging and met adolescents’ needs.