Adaptation of the Digital Health Literacy Instrument and testing with German school-aged children

BACKGROUND: Children and adolescents in particular navigate in the digital space intensively and use the Internet, social media, and apps to seek health related information. From a public health perspective, the increasing amount of online-based information requires them to possess the abilities to find, understand, evaluate, and apply health information, making digital health literacy more and more important. The Digital Health Literacy Instruments (DHLI) is a psychometrically tested instrument for assessing digital health literacy in adults, which has been adapted for children and adolescents in the United States, using cognitive interviews. However, this version has not yet been adapted for Germany. Hence, the aim of this study is to adapt and test a German version of DHLI for secondary schoolchildren. METHODS: The pretest tool was translated into German by three native speakers. To test the translated version of the DHLI adapted for secondary schoolchildren, cognitive pretests were conducted with N = 12 children and adolescents aged 10-17 years. The thinking aloud method and probing questions were used during the pretests. The aim of the evaluation was to maximize usability and comprehensibility of the adapted version for schoolchildren in Germany. RESULTS: In order to adapt the instrument for a German target group, preferred synonyms were identified during the pretests, as well as a preferred word collocation for health information, namely ‘information about health,’ which was used consistently for all items. Furthermore, two explanations were added in one instruction and one item. CONCLUSIONS: Based on the results of the pretest analysis, a German version of the DHLI for children and adolescents is now available. Psychometric properties and the methodological quality of the schoolchildren's version of the DHLI have been analyzed in a representative quantitative study, shown in the subsequent presentation.