Background: Children and adolescents extensively use the internet in their daily lives, often seeking information related to health and well-being. In modern society, the volume of health information available in digital environments is constantly increasing. This includes both reliable and misleading content, making it challenging to assess trustworthiness. Digital health literacy is essential for navigating the digital information ecosystem, protecting oneself from misinformation, and making informed health decisions. Objective: This representative study aims to examine the 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 utilized to collect data from 1448 children and adolescents aged 9-18 years in Germany between October and November 2022. Digital health literacy was assessed using an adapted and translated version of the Digital Health Literacy Instrument (DHLI), which comprises 7 subscales: operational skills, navigation skills, information searching, self-generated content, evaluating reliability, protecting privacy, and determining relevance. Bivariate and binary logistic regression analyses were conducted to examine associations between digital health literacy subscales and sociodemographic characteristics (sex, age, migration background, school type, and perceived family affluence). Results: The study found that 419 out of 1362 (30.76%) children and adolescents had a problematic level of digital health literacy, while 63 out of 1362 (4.63%) had an inadequate level. Overall, the least difficulties were observed in operational skills and determining relevance, whereas the greatest challenges were related to protecting privacy and navigation skills. Age was significantly associated with 6 of the 7 subscales (excluding protecting privacy), with younger children (9-11 years) facing a higher risk of limited skills (operational skills: odds ratio [OR] 5.42, P=.002; navigation skills: OR 4.76, P<.001; information searching: OR 4.68, P<.001; adding self-generated content: OR 7.03, P<.001; evaluating reliability: OR 3.82, P<.001; and determining relevance: OR 4.76.42, P<.001). Migration background was associated with fewer limited digital health literacy skills, while low perceived family affluence was associated with more limited skills. In the subscales of information searching, self-generated content, and evaluating information reliability, a lower risk of limited skills was observed among those with a 2-sided migration background (information searching: OR 0.62, P=.02; adding self-generated content: OR 0.30, P=.003; and evaluating reliability: OR 0.66, P=.03). By contrast, a higher risk was found among those with low perceived family affluence, including in the subscale of determining relevance (information searching: OR 2.18, P<.001; adding self-generated content: OR 1.77, P=.01; evaluating reliability: OR 1.67, P<.001; and determining relevance: OR 1.58, P<.001). Although school type was not associated with any dimension, sex was linked to operational skills, with females having an increased risk of limited skills (OR 1.58, P=.03). Conclusions: The results highlight a strong need for interventions to improve digital health literacy among children and adolescents, particularly in protecting privacy, navigation skills, and evaluating the reliability of health information. Effective interventions should be tailored to address the varying needs associated with age, migration background, and family affluence.

Background: The present study investigates the role of different sources of social support in the relationship of BMI and PA in an international sample of children and adolescents. Methods: Data included 170,211 adolescents (51.5% female), aged 10–16 (M = 13.6, SD = 1.64) from 37 European countries/regions and were retrieved from the 2013/14 Health Behaviour in School-aged Children (HBSC) international database. Results: PA levels in adolescents are lower for girls, decrease with age, and are lower for overweight and obese adolescents compared to underweight and normal-weight adolescents. Peer support and teacher support significantly predict PA (OR_peer = 1.11; OR_teacher = 0.97) and vigorous PA frequency (OR_peer = 1.13; OR_teacher = 0.94). Family support only affected vigorous PA frequency (OR = 1.03). Family support had a moderating effect on PA in overweight (OR_{family*BMI(overweight)} = 0.94) and obese (OR_{family*BMI(obese)} = 0.90) adolescents. Peer support had a moderating effect on vigorous PA frequency in obese (OR_{peer*BMI(obese)} = 1.08) adolescents. Teacher support had a moderating effect on PA (OR_{teacher*BMI(normal)} = 1.05; OR_{teacher*BMI(overweight)} = 1.09) and vigorous PA frequency (OR_{teacher*BMI(normal)} = 1.07; OR_{teacher*BMI(overweight)} = 1.08) in normal-weight and overweight adolescents. Conclusion: Social support helps adolescents to be active. Especially for obese adolescents, support by and relations with peers are important to reach a significant amount of PA.

Active travel in adolescence contributes to improved health outcomes. Self-Determination Theory suggests that motivation and basic psychological needs influence travel behavior. Person-centered approaches can examine interrelationships of these constructs underlying travel behavior. The aim of this study was to investigate (i) which clusters can be identified in adolescents, (ii) whether clusters explain overall active travel behavior, (iii) whether clusters were associated with travel mode to various destinations or distance, and (iv) whether differences across clusters appear regarding sex/gender, age, and weight status. The sample included 517 (263 male, 254 female) adolescents from Germany, aged 11–15. Self-organizing maps analysis identified six clusters from nine input variables: intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, amotivation, autonomy satisfaction, competence satisfaction, and relatedness satisfaction. The most beneficial cluster regarding active travel demonstrated highest basic psychological needs satisfaction and autonomous motivation with low controlled motivation and amotivation. The most vulnerable cluster was characterized by generally low levels of motivation except for external regulation and amotivation. Clusters were not associated with distance to school, friends/relatives, shopping facilities, or leisure facilities. The findings support the importance of high quality and high quantity of motivation for active travel in adolescents.

Active travel can contribute to multiple health benefits in youth. Previous research has identified several factors influencing travel behavior. This study investigates how adolescents process these factors during their decision-making process on travel mode choice. Semi-structured interviews were conducted with 13 adolescents (11–14 years) and analysed using deductive–inductive thematic analysis. Four themes were generated from which the decision-making process on mode choice was conceptualized according to adolescents. The step-by-step process in which travel mode options were gradually reduced, was dependent on the context (Theme 1), the perceived availability of travel mode choice options, which was influenced by factors beyond the individual’s perceived control (Theme 2), and on adolescents’ pros/cons assessment to identify the most convenient option. Adolescents’ habitually used travel mode influenced the decision at several stages throughout the process (Theme 4). To promote healthy travel behaviors, interventions should consider contextual circumstances, balance between enabling autonomous choices and promoting advantages of active travel modes, address individual travel modes and include practices that foster conscious processing of decision-making.

Zusammenfassung: Hintergrund: Digitale Informationsquellen bieten Jugendlichen schnellen Zugang zu gesundheitsbezogenen Informationen. Schulen sind ideal, um die digitale Gesundheitskompetenz (dGK) zu fördern und Schülerinnen und Schülern (SuS) einen sicheren Umgang mit solchen Informationen zu ermöglichen. Ziel dieses Beitrags ist es, erste Ergebnisse einer repräsentativen Studie zum Erlernen von dGK in Schulen mit Blick auf soziodemografische und sozioökonomische Unterschiede vorzustellen. Methoden: Durchgeführt wurde eine Querschnittsstudie mit 1448 SuS (9 bis 18 Jahre) in Deutschland im Rahmen des Projekts DURCHBLICKT!. Über bivariate und multivariate Analysen wurden Unterschiede und Zusammenhänge im Erlernen der dGK und Geschlecht, Alter, Migrationshintergrund sowie subjektiven Sozialstatus überprüft. Ergebnisse: Etwa 50 % der SuS gaben an, dGK (eher) nicht in der Schule erlernt zu haben. Der Chi-Quadrat-Test zeigt signifikante Unterschiede in Bezug auf Geschlecht, Alter, Migrationshintergrund und Sozialstatus. Regressionsanalysen zeigen, dass besonders das Alter und der subjektive Sozialstatus bedeutende Faktoren für das Erlernen der dGK sind. Diskussion: Die hohe Zahl der SuS, die dGK nicht in der Schule erlernen, ist besorgniserregend, vor allem im Hinblick auf ihre oft geringe dGK. Die Ergebnisse verdeutlichen die Notwendigkeit gezielter Bildungsstrategien – insbesondere solche, die auf Geschlecht und sozioökonomischen Status abgestimmt sind –, um dGK zu fördern und soziale Ungleichheiten zu verringern.