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: With their influence on health behavior of children, families are important addressees in health promotion and prevention of chronic diseases. However, they are often difficult to reach, partly due to the open approach of health promotion services. Therefore, they should be addressed directly and be involved in shaping their living environment. The aim is to examine which approaches are used in participatory family health promotion and what practical experiences are made. Methods: A systematic literature search in PubMed, Web of Science, LIVIVO and a supplementary hand search were conducted. Ten of 718 screened publications were analyzed qualitatively. Results: Most included publications applied the community-led participatory approach CBPR. In seven publications, family actors could make decisions at any or all project phases. One finding is that positive effects on desired behavior change and improved health of target groups were observed. Frequently described success factors are the type of interaction, and a common goal. Conclusion: The forms of family participation in health promotion vary widely, with the lack of participatory practices being a major challenge. Family participation is a useful approach in shaping health promotion and should be further developed. This overview provides support for planning future participatory projects with families.

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.

Zusammenfassung: Hintergrund: Die digitale Gesundheitskompetenz (dGK) wird vor dem Hintergrund einer stetig wachsenden Informationsdichte im digitalen Raum als Ressource für gesundheitliche Entscheidungen und Handlungen immer wichtiger. Dabei stellt die Schule ein geeignetes Setting zur Förderung von dGK dar, was die dGK des Schulpersonals explizit einschließt. Der vorliegende Beitrag zielt auf die Entwicklung und Umsetzung eines online-basierten Selbstbewertungsinstruments der dGK von Schulpersonal. Methoden: Die Entwicklung der Indikatoren des Kurzinstruments erfolgte auf Grundlage der Analyse von Daten einer Studie mit 1181 Lehrkräften sowie einer ergänzenden Literaturrecherche von relevanten Instrumenten. Im Anschluss an die Entwicklung einer Auswertungsstrategie erfolgte die technische Umsetzung sowie die Pilotierung und Finalisierung des Instruments. Ergebnisse: Das Kurzinstrument umfasst 20 Indikatoren zu drei übergeordneten Themenbereichen: (1) individuelle dGK, (2) Einstellungen und Kompetenzeinschätzung zur Vermittlung von dGK sowie (3) Medienkompetenz. Die Rückmeldung der Ergebnisse erfolgt in einer nach Handlungsbedarf priorisierten Darstellung sowohl für die übergeordneten Themenbereiche als auch für die einzelnen Indikatoren. Schlussfolgerung: Das nun vorliegende Kurzinstrument bietet eine niedrigschwellige Möglichkeit zur Selbstbewertung der individuellen dGK von Schulpersonal in Deutschland. Im Sinne klassischer Handlungszyklen ermöglicht es den ersten Schritt (Bedarfsbestimmung) in der Interventionsentwicklung. Die gewonnenen Daten tragen überdies dazu bei, den Erkenntnismangel der dGK bei Schulpersonal zu schließen.

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.