Enhancing digital health literacy in adolescents: evaluation of a co-designed educational app.

BACKGROUND: With more people turning to the unregulated environment of the internet for health information, digital health literacy is increasingly important to assess trustworthiness of online health information. Adolescents' digital health literacy has long been overlooked because of the false assumption that they possess advanced skills due to being raised in a digital age. It is important that adolescents are given opportunities to develop their digital health literacy, however there is a lack of relevant educational resources, especially self-directed online resources. With adolescents, we co-designed a digital health literacy educational resource. In this study we aimed to evaluate its effectiveness at enhancing adolescents' digital health literacy. METHODS: The study utilised a pre/post mixed-method design with 12-17-year-olds. One-on-one video conference meetings were held with participants. Participants completed a digital health literacy self-assessment survey and practical search task before and after using the brief educational resource misAdventures (10-15 min), then completed an evaluation survey. Survey data were analysed using descriptive statistics; the search task was analysed using an observational checklist; inductive content analysis of qualitative data identified key themes in search and appraisal behaviours. RESULTS: For most of the 30 participants, there was a general increase in self-assessed digital health literacy post-intervention. Improvements in appraising the trustworthiness of online health information were seen across multiple search and appraisal skills, including choosing government or official health websites and cross-checking information. Most participants combed through search engine results listings to identify trustworthy sources rather than relying on Google suggestions or the top search result. Some skills, such as investigating bias, were not demonstrated pre- or post-intervention. Evaluation survey results indicated the app was easy to use (100% agreement), with 90% of participants reporting they could see they were learning while using the app and it would change how they use online health information. CONCLUSION: Use of the co-designed educational resource misAdventures improved adolescents' digital health literacy and self-efficacy. Adolescents acknowledged they learnt through using the app and believed it would change the way they used online health information. A brief, self-directed digital educational resource can improve adolescents' ability and disposition to identify trustworthy health information online and on social media.